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Objectives: To document temporal trends in maternal overweight and obesity in Australian women and to examine associations with pregnancy outcomes.

Design, setting and participants: Retrospective 12‐year cohort study of 75 432 women with singleton pregnancies who had pre‐pregnancy height and weight data available and who gave birth in a tertiary referral maternity hospital in Brisbane between January 1998 and December 2009.

Main outcome measures: Maternal body mass index (BMI); prevalence of overweight and obesity, and pregnancy complications including hypertension, gestational diabetes, caesarean delivery, and perinatal morbidity and mortality.

Results: From 1998 to 2009, class III and class II obesity increased significantly (from 1.2% to 2.0%, and 2.5% to 3.2%, respectively), while the proportions of underweight women and those with class I obesity fell slightly (from 7.9% to 7.4%, and 7.7 …