Objective To explore clinical outcomes and conduct a comprehensive analysis in the 110 pregnant women with hypothyroxinemia in early and mid-pregnancy (HEMP). Methods A total of 110 patients with HEMP admitted to the hospital were retrospectively analyzed between December 2022 and July 2024. According to different intervention methods, they were divided into routine intervention group (n=48, routine intervention) and drug intervention group (n=62, levothyroxine sodium tablets on basis of routine intervention group). A total of 100 normal pregnant women undergoing antenatal examination during the same period were enrolled as healthy control group. The pregnancy outcomes and pregnancy-related complications in the three groups were compared. The neonatal health status was evaluated by Apgar scores. The neonatal neural development was evaluated by neonatal behavioral neurological assessment (NBNA). The development status of neonatal motor function and psychological function was evaluated by motor development index (MDI) and psychological development index (PDI). Results There was no significant difference in adverse pregnancy outcomes among the three groups (P>0.05), and there was also no significant difference in neonatal Apgar score or NBNA score among the three groups (P>0.05). The scores of MDI and PDI were gradually increased in healthy control group, routine intervention group and drug intervention group (P<0.05). Conclusion HEMP will not affect the incidence of adverse pregnancy outcomes in pregnant women, but it may affect neonatal motor and psychological development.