The clinical and nutritional status of pregnant women are important variables for birth-weight risk inadequacies. Thus, this study sought to evaluate the nutritional status of high-risk pregnant women and its association with birth weight of their offspring. It involved a cross-sectional study with high-risk pregnant women assisted at the university hospital of Maceio in the State of Alagoas and their newborns. The nutritional status of pregnant women and their offspring was evaluated according to body mass index for gestational age and birth weight, respectively. The association between maternal factors (comorbidities and nutritional status) and birth weight was assessed by the chi-square test and Pearson correlation, by adopting a confidence level of 95%. One hundred and forty-nine pregnant women were studied, 19.7% of whom were of normal weight; 32% were underweight; and 48.3% were overweight. Among newborns, 39.6% referred to as small for gestational age (SGA); 26.8% appropriate for gestational age (AGA) and 33.6% large for gestational age (LGA). LGA offspring were associated with overweight and the presence of metabolic comorbidities and SGA offspring were associated with insufficient gestational weight gain, whereby interventions are needed to reduce these outcomes.