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Objective: To evaluate the prevalence of oral mucosal lesions (OML) and oral self‐examination and their associated factors among pregnant women from the 2015 Pelotas Birth Cohort Study, Brazil. Methods: Pregnant women who would deliver babies in 2015 were included in the antenatal study. Data related to demographic, socio‐economic and behavioural conditions were collected using questionnaires. Participants were also clinically assessed for oral health outcomes. The outcomes were the presence of OMLs and oral self‐examination. Size, location, time of onset and symptomatology of the lesions were collected. Descriptive and bivariate analysis, and Poisson regression were performed. p‐Value <0.05 was set to indicate statistical significance. Results: Data from 2481 pregnant women were analysed. Four hundred and nine (16.5%) had at least one OML. The most prevalent lesions were exostosis (80/16.6%), coated tongue (70/14.5%) and benign oral brownish pigmentation (68/14.1%). Non‐white skin colour was associated with a higher prevalence of OMLs (PR 1.3; 95% CI 1.1–1.6), while daily use of dental floss was positively associated with the prevalence of oral self‐examination (PR 1.4; 95% CI 1.2; 1.5). Conclusions: Almost 20% of pregnant women presented OML, which were more prevalent in non‐white individuals. Women with better oral care were more likely to perform oral self‐examination. [ABSTRACT FROM AUTHOR]