Abstract: Objective To explore the characteristics of automatic dysfunction in pregnant women with gestational hypertension and its clinical significance. Methods Eighty-two pregnant women with gestational hypertension (observation group) and 50 healthy pregnant women (control group) in our hospital from January, 2016 to January, 2017 were prospectively collected. The heart rate variability of both groups was observed. The correlation between the heart rate variability and pregnancy outcome was studied. Results Compared with the control group, 24 h standard deviation of sinus R-R intervals of the observation group decreased significantly[(97.54 ±9.63) ms vs. 110.92 ±9.21 ms, P<0.001];each 5 min mean standard deviation of sinus R-R interval decreased significantly (101.56 ±9.47 vs. 109.32 ±9.42 ms, P<0.001); 24 h continuous 5 min standard deviation of sinus R-R interval decreased significantly[(41.47 ±8.83) vs. 45.82 ±8.71 ms, P=0.007]; all near the sinus R-R interval difference decreased significantly (27.82 ±9.23 vs.31.91 ±9.55 ms, P=0.016); a percentage of all the number of heart beat the number of all the two adjacent sinus RR interval difference was greater than 50 ms, which decreased significantly (10.21 ±2.38 vs. 13.38 ±4.91, P<0.001). The decrease of heart rate variability of the pregnant women in the observation group was divided into normal, mild, moderate and severe, and the value was 50.00%, 39.02%, 8.54% and 2.44%, respectively, and in the control group was 80.00%, 18.00%, 2.00% and 0.00%, respectively, P=0.006. According to the analyses of sub-group, the cesarean section rate, premature rate and 24-hour urinary albumin content in the gestational hypertension pregnant women with decreased heart rate variability increased significantly (P<0.05). Conclusion The automatic functional impairment in the pregnant women with hypertension is serious, which can lead to poor pregnancy outcome.