Objectives: To analyze the prevalence of major depression disorder, anxiety disorders and substance abuse in women with high-risk pregnancy and identify maternal-fetal pathologies and other variables associated with higher prevalence of mental disorders. Methodology: This cross-sectional study included 46 women in the high-risk gestation outpatient clinic of the Maternidade Escola Assis Chateaubriand in Fortaleza - Ceará. A sociodemographic and a clinical data questionnaire were applied, as well as Abuse Assesment Screen, Edinburgh Postpartum Depression Scale, State-Trait Anxiety Inventory and Alcohol Smoking and Substance Screening Test. Mini International Neuropsychiatry Interview (MINI) was applied to women with positive screening in the mentioned scales. Results: Using the screening tools, the prevalence was 30.4% for depression and 52.2% for anxiety; with the MINI the prevalence was 30,4% and 34,8%, respectively. Pregnant women with cardiac diseases had a 66,7% depression prevalence and a 77.8% anxiety prevalence, both higher than those with other pathologies. Depression and anxiety were also associated with unwanted pregnancy and domestic violence during life. Conclusion: The prevalence of depression and anxiety was high in this sample of pregnant women and the associated risk factors need to be understood, so that better interventions in the treatment of pregnant women can be implemented.