ObjectiveThis study aims to investigate the prevalence of depression, anxiety and insomnia in pregnant Chinese women, and to explore the related risk factors across multiple fields.MethodThe participants were 2120 women (Mage = 30.24 years, range = 19-47) from 12 provinces in China. Bivariate correlation and logistic regression analyses were used to explore the risk factors. Chi-square tests and t tests were used to examine whether there were significant differences in mental health status between pregnant women in different periods of gestation.ResultsThe overall prevalence rates of depression, anxiety and insomnia among pregnant Chinese women were 10.0%, 3.8% and 3.3%, respectively. Risk factors for the mental health of pregnant women were identified across demographic, maternal, physiological, and psychological domains. Among these, severe mobility restrictions and fear of childbirth were found to be the strongest predictors.ConclusionsThe prevalence of depression, anxiety and insomnia among pregnant women is low. Pregnant women with a seriously impaired ability to move and fear of childbirth are more likely to experience mental health problems. What is already known about this topic:Depression, anxiety, and insomnia are common mental health problems among pregnant women.Prevalence rates vary significantly across different countries and regions. Particularly in a large country like China, prevalence rates differ substantially among different regions.While risk factors for mental health of pregnant women span multiple domains, such as physiological and demographic domains, the most influential factors remain unclear.What this topic adds:A large-scale study from 12 provinces in China showed relatively low prevalence rates of depression, anxiety, and insomnia among pregnant women.Among the numerous factors influencing mental health, severe mobility restrictions and fear of childbirth emerged as the most robust predictors.