Objective To investigate psychological health status and factors associated with pregnant women in Mudanjiang, Heilongjiang Province, so as to provide scientific evidence for improving the quality of perinatal health care.

Methods Convenient sampling was used to recruit 686 pregnant women who participated in obstetric examination and planned to deliver babies in 3 grade A tertiary hospitals as study subjects in Mudanjiang, Heilongjiang Province. Questionnaire survey was conducted to investigate psychological health status, fatigue and sleep quality among pregnant women through Symptom Check List 90 (SCL-90), Fatigue Assessment Instrument and Pittsburgh Sleep Quality Index. Multivariate logistic regression analysis was used to explore the factors associated with mental health status among pregnant women.

Results The average screening positive rate of psychological problems was 30.03% (31.91% in the first trimester, 27.84% in the second trimester, and 31.25% in the third trimester). Univariate analysis showed that pregnant women’s mental health was affected by the number of pregnancies, couple sentiment, the relationship with parents-in-law, fatigue and sleep quality (all P < 0.05). Multivariate logistic regression analysis showed that pregnant women with sleep disorders, moderate and severe fatigue had higher risk of screening for psychological problems, and the risk were lower in women ≥ 2 pregnancies, good couple sentiment, and good relationship with parents-in-law (all P < 0.05).

Conclusion Pregnant women’s mental health can be affected by sleep quality, fatigue, couple sentiment, and the relationship with parents-in-law and other factors. Their mental health status can’t be ignored, and comprehensive intervention measures should be taken to improve their mental health.