Objective This study aims to investigate the serum levels of estrone(E1)and estriol(E3)in pregnant women with threatened miscarriage and evaluate their predictive value for adverse pregnancy outcomes.The findings will provide valuable reference for early clinical intervention and treatment.Methods A total of 122 pregnant women with threatened abortion who were admitted to Guangyuan Maternal and Child Health Hospital from January 2020 to December 2021 were selected.Based on whether they experienced a miscarriage,the pregnant women with threatened abortion were divided into two groups:the good pregnancy outcome group(n=80)and the poor pregnancy outcome group(n=42).Additionally,70 normal pregnant women of the same age who delivered in our hospital were selected as the control group.The levels of E1 and E3 in serum were compared among the different groups.Pearson analysis was used to evaluate the correlation between E1 and E3 levels and other related hormones in serum.Furthermore,we conducted binary logistic a-nalysis to analyze the factors contributing to poor pregnancy outcomes.Lastly,we used ROC curve analysis to assess the diagnostic value of E1 and E3 levels in predicting poor pregnancy outcomes.Results The serum levels of β-human cho-rionic gonadotropin(β-HCG),progesterone(P),estradiol(E2),E1,and E3 in the poor pregnancy outcome group were lower than those compared to both the control group and the good pregnancy outcome group(P<0.05).Conversely,the levels of high sensitivity C-reactive protein and cancer antigen 125 in serum were higher compared to the control group and the good pregnancy outcome group(P<0.05).There was a positive correlation between the serum levels of E1,E3,β-HCG,P,and E2 were positively correlated(P<0.05).Binary logistic regression analysis showed that elevated E1 and E3 were influencing protective factors against adverse pregnancy outcomes(P<0.05).The ROC curve demonstrated that the combined diagnosis of E1 and E3(0.841)had a significantly higher area under the curve(AUC)compared to using E1(0.745)or E3(0.735)alone.The sensitivity and specificity of the combined diagnosis were 85.71%and 86.00%,respectively.Conclusion The levels of E1 and E3 in serum decreased in pregnant women experiencing poor pregnancy outcomes.The combined diagnosis of E1 and E3 has a good diagnostic efficiency for identifying poor pregnancy outcomes,offering a valuable foundation for early clinical intervention and treatment.