ObjectiveThis study aimed to describe the pregnancy outcomes in patients with primary Sjögren's syndrome (SjD) and identify risk factors for adverse pregnancy outcomes (APO) in a prospective single center study.MethodsWe described the outcomes of 114 pregnant women who fulfilled the established criteria for SjD and analyzed the risk factors for adverse outcomes using multiple factors logistic regression.ResultsThe fetal and maternal outcomes in 114 pregnancies were as follows:100 (87.7%) live births, 11(9.6%) miscarriages (first-trimester pregnancy loss), three (2.6%) stillbirths, six (5.3%) cases with intrauterine growth restriction, five (4.1%) preterm deliveries, seven (6.1%) cases with small-for-gestational-age birth weight, and five (4.4%) cases with preeclampsia or eclampsia. Multivariate analysis revealed that age at pregnancy (odds ratio [OR]:1.402, P = 0.016), anti-U1-ribonucleoprotein antibody positivity (OR = 3.562, P = 0.029), and subchorionic hemorrhage (OR = 7.652, P = 0.002) were independent predictors of APO.ConclusionIn our cohort, women with subchorionic hemorrhage or anti-U1RNP antibody positivity require close monitoring because these factors are associated with a higher risk of APO.