Background <p>Gestational diabetes mellitus (GDM) poses a significant threat to the health of both the mother and the fetus during pregnancy, potentially resulting in adverse pregnancy outcomes (APOs), including preterm labor and obstructed labor.</p> Objective <p>This study aimed to evaluate the expression of serum microRNA (miR)-92a-3p and miR-182-3p in GDM and their clinical significance, providing ideas for clinical diagnosis and management.</p> Methods <p>A total of 80 patients with GDM served as the GDM group, and 80 healthy pregnant females served as controls. Quantitative real-time PCR was utilized to examine the relative expression of miR-92a-3p and miR-182-3p. Logistic regression modeling and ROC curves were utilized to evaluate the clinical significance of serum miR-92a-3p and miR-182-3p in GDM.</p> Results <p>miR-92a-3p and miR-182-3p was upregulated in GDM patients. The expression of miR-92a-3p and miR-182-3p were positively correlated with 1&#xa0;h OGTT, 2&#xa0;h OGTT, and HOMA-IR. The ROC curves demonstrated that the areas under the curve (AUCs) of miR-92a-3p, miR-182-3p, and the combination of the two in the diagnosis of GDM were 0.890, 0.813, and 0.921, respectively. Elevated levels of serum miR-92a-3p and miR-182-3p were linked to APOs. The AUCs of miR-92a-3p, miR-182-3p, and the combination of the two for predicting APOs were 0.795, 0.775, and 0.845, respectively.</p> Conclusion <p>miR-92a-3p and miR-182-3p exhibited diagnostic value for GDM and were correlated with APOs in patients.</p>