Maintaining a healthy diet during pregnancy is vital for reducing the risk of adverse birth outcomes. However, conventional methods of assessing the dietary behavior of pregnant women, such as the FFQ, are often time-consuming. This study aims to develop a concise nutritional screening questionnaire tailored for pregnant women, empowering prenatal healthcare providers to quickly identify key adverse dietary behaviors and provide targeted guidance.To validate the Pregnancy Nutrition Checklist, we enrolled 208 women in early pregnancy and 200 women were included to analysis (with an average age of 31.54 ± 4.24 years). Spearman rank correlation analysis was used to assess the relative reliability of the Pregnancy Nutrition Checklist compared with the FFQ scale. Exploratory factor analysis was used to test the structural validity of the scale. A generalized linear model was used to analyze the correlation between dietary behavior and birth weight.The pregnancy nutrition checklist includes 15 dietary items and 3 other lifestyle habit items. Compared with traditional FFQ questionnaires, the correlation analysis of corresponding items in the pregnancy nutrition checklist revealed statistical significance (p < 0.05), except for fat intake. EFA identified three underlying factors, namely, "high-fat foods," "moderate-fat foods," and "low-fat foods," indicating that the questionnaire has good construct validity. Insufficient consumption of vegetables by pregnant women(OR = 2.64, 95% CI: 1.08-6.46, p = 0.033) was associated with a significantly greater risk of developing LGA fetuses. Pregnant women whose sugar, coffee, or tea intake did not exceed the classification criteria had significantly greater fetal birth weights than those whose intake exceeded the classification criteria (OR = 3.38, 95% CI: 1.18-9.68, p = 0.023). In contrast, consuming fewer highly palatable snacks can reduce the incidence of LGA babies (OR = 0.29, 95% CI: 0.11-0.74, p = 0.010).This tool has great potential for identifying unhealthy dietary behaviors, potentially leading to improved pregnancy outcomes.This study was preregistered on May 5, 2023, at the Chinese Clinical Trial Registry (ChiCTR2300071126).© 2024. The Author(s).