Objective To investigate the effect of body weight and body composition management on pregnancy outcomes in obese pregnant women.Methods A total of 161 obese pregnant women who visited Dalian Women and Children's Medical Group from January 2020 to October 2021 were selected as the research objects.According to the random number table method,they were divided into the experimental group(80 cases)and the control group(81 cases).The body weight gain and body composition before and after intervention,and pregnancy outcome were compared between the two groups.Results The weight gain,body fat percentage and fat mass of pregnant women in the experimental group after intervention were lower than those in the control group,and the differences were statistically significant (P＜0.05).The incidence of gestational diabetes mellitus,gestational hypertension,cesarean section,neonatal birth weight,macrosomia,postpartum hemorrhage,prolonged or stalled labor,premature rupture of membranes,and fetal distress in the experimental group were lower than those in the control group.The neonatal Apgar score of the observation group was higher than that of the control group,and the difference was statistically significant (P＜0.05).Conclusion Combined intervention during pregnancy can improve the weight gain and body composition of obese pregnant women,reduce the incidence of pregnancy complications,and improve pregnancy outcomes.