Background <p>Pregnancy is one of the periods when women of reproductive age have a high risk of weight gain, and maternal obesity is an important risk factor in this period. This study aimed to investigate the predictive factors of maternal obesity and its impact on pregnancy symptoms and sexual function in pregnant women living in the Eastern Mediterranean region of southern Türkiye.</p> Methods <p>This study utilized a cross-sectional, hospital-based, and multi-center design. The study was participated in by 647 pregnant women. Data were collected through the Socio-demographic Form, the Pregnancy Symptoms Inventory, and the Female Sexual Function Index.</p> Results <p>The obesity prevalence of pregnant women was 36.6% in this study. This study found that maternal obesity was a predictive factor on pregnancy symptoms (<i>p</i> &lt; 0.05). However, no difference was found between FSFI scores according to pregnancy symptoms in obese and non-obese pregnant women (<i>p</i> &gt; 0.05).</p> Conclusions <p>Quality pre-conceptional midwifery care and consultancy accompanied by regular pregnancy follow-ups are considered to prevent the development of maternal obesity, pregnancy complaints, and sexual dysfunction and be a fundamental step that can improve maternal health.</p>