Objective To explore the influence of fertility dance on the fear of childbirth，childbirth self-efficacy and delivery outcomes of pregnant women with gestational diabetes mellitus （GDM）. Methods A total of 258 GDM pregnant women who visited Bozhou People's Hospital from December 2021 to December 2023 were selected for the study. They were divided into the intervention group （n=115） and the no-intervention group （n=143） based on whether they received the fertility dance intervention. Another 150 healthy pregnant women who were examined at the same hospital during the same period were selected as the control group for the study. All pregnant women were matched by propensity score at a ratio of 1：1：1. After matching，each group consisted of 115 pregnant women. The general data of the pregnant women before and after propensity score matching were compared，and the balance of covariates after propensity score matching was tested. The duration of labor，blood glucose indicators before and after intervention，fear scores before and after intervention，self-efficacy scores before and after intervention，and delivery outcomes of the three groups of pregnant women were compared. The generalized estimating equation was used to compare the fear scores of pregnant women in the intervention group and the no-intervention group. The generalized linear mixed model （GLMM） was used to analyze the relationship between fertility dance and adverse delivery outcomes in GDM pregnant women. Results （1）The duration of the first，second，and third stages of labor as well as the total labor duration in the intervention group was significantly shorter than that in the no-intervention group and the control group （P<0.05）.（2）After the intervention，the fasting blood glucose，2-hour post-meal blood glucose，and glycosylated hemoglobin levels in the intervention group were significantly lower than those in the no-intervention group，and they were also significantly lower than those before the intervention （P<0.05）.（3）After the intervention，the scores of hospital environment and intervention fear，fear of newborn health，fear of losing control，and fear of pain and injury in the intervention group were significantly lower than those in the no-intervention group，and were significantly lower than those before the intervention （P<0.05）.（4）After the intervention，the self-efficacy scores of the intervention group were significantly higher than those of the no-intervention group，and they also showed a significant increase compared to those before the intervention （P<0.05）.（5）The incidence of perineal lateral incision injury，fetal distress，and neonatal 1-minute Apgar score≤7 points in the intervention group was significantly lower than that in the no-intervention group（P<0.05）.（6）The results of the generalized estimating equation analysis showed that the scores for neonatal health fear，fear of hospital environment and intervention，fear of pain and injury，and fear of losing control in the intervention group improved significantly more than those in the no-intervention group （P<0.05）. （7）The results of the GLMM model analysis showed that after adjusting for confounding factors，the risk of adverse delivery outcomes for the intervention group was still significantly lower than that for the no-intervention group （OR=0.721，95% CI 0.419-0.816，P<0.001）. Conclusion The fertility dance intervention can significantly reduce the fear of childbirth in women with gestational diabetes，enhance their self-efficacy during childbirth，and improve adverse delivery outcomes.