A growing body of research reports an association between adverse childhood experiences (ACEs) and severe physiological and psychological health problems. Recent studies suggested that positive childhood experiences (PCEs) may bestow a protective buffer against the negative impacts of ACEs. The current study examined the effect of ACEs/PCEs on pregnancy outcomes, including unhealthy gestational weight gain (UWG), gestational diabetes (GD), preterm birth, and small or large birth weight for gestational age (SGA or LGA). The study sample included 556 women who enrolled in the MotherToBaby, delivered a live singleton from 2015-2021, and completed the Positive and Adverse Childhood Experiences survey between September 2020 and February 2021. Women who reported ≥ 3 ACEs or physical/emotional abuse had increased aOR = 1.68, 95% CI [1.12, 2.51]) or aOR = 1.79, 95% CI [1.24, 2.59] for UWG. Although sexual abuse or household dysfunction had elevated point estimates with increased odds for GD, SGA, and LGA or UWG, preterm birth, and LGA, the associations were not statistically significant with large confidence intervals. Additionally, due to the small sample size within stratified outcomes, we were unable to assess the effect modification of PCEs. Further research may advance an understanding of associations between timing, frequency, and types of ACEs/ PCEs and pregnancy health which could facilitate ACE awareness, reduce medical costs in maternal health care, and provide a better beginning for infant development.