Based on neonatal nursing installation data at Arifin Achmad Regional Hospital in Riau Province, newborns with low birth weight have always been the highest cases.Objective: This study aimed to examine the effect of macronutrient status (carbohydrate, protein, fat) and gestational weight gain on pregnancy outcomes.Method: The design used in this study was case-control. The study sample was 74 respondents, the case group was 37 mothers with babies born with low birth weight and the control group

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... was 37 mothers with babies born with normal birth weight. Macronutrient intake was collected with a food frequency questionnaire (FFQ). Data were analyzed by using the Chi-Square test (p<0,05).Results: Intake of low carbohydrate has 3 times risk for low birth weight (OR=3.46; 95%CI:1.25-9.47), intake of low fat has 5 times risk for low birth weight (OR=5.11; 95%CI:1.88-13.93), and intake of low protein has a 12 times risk for low birth weight (OR=12.21; 95%CI:3,97-37,94). A gestational weight gain is not following the IOM recommendations increased the risk of giving birth to a low weight baby (OR=3,96; 95%CI:1,49-10,53).Conclusion: Pregnant women with a low intake of carbohydrates, proteins, fats, and weight gain are not following the recommended increased the risk of giving birth to a low weight baby.