Abstract: Objective To explore the value of detection of related genes of prethrombotic state(PTS)in predicting adverse pregnancy. Methods Totally 154 female patients with history of adverse pregnancy outcomes were selected. Polymerase chain reaction(PCR)and capillary electrophoresis(CE)sequencing method were used to analyze coagulation factor Ⅴ(FⅤ), coagulation factor Ⅱ(FⅡ), plasminogen activator inhibitor-1(PAI-1)5G/4G, methylenetetrahydrofolate reductase(MTHFR)677 genotype, MTHFR 1298 genotype and mutation sites of methionine synthetic reductase(MTRR). The pregnancy outcome was followed up to analyze the frequency of different gene polymorphisms. Results The results showed that there were 18 cases with low risk, 91 cases with medium risk and 45 cases with high risk. In this study, we found that the genotype of FⅤ gene 1691 and genotype of FⅡ gene 20210 were GG, but the risk level had no correlation with FⅤ and FⅡ genotypes, nationality and age, but had correlation with the history of fetal arrest. With the increase of risk level, the ratios of cases with the history of fetal arrest, PAI-1 gene-675 genotype 5G/5G and MTHFR gene 677 genotype TT increased gradually. Calculated by the number of patients with moderate and high risks, the positive rate of PTS was 88.31%, which was significantly correlated with spontaneous abortion and recurrent abortion(P<0.01). Conclusion Early spontaneous abortion and recurrent abortion are closely related to PTS gene mutation.