Aim: Determining the prevalence of metabolic syndrome (MS) in the tested sample of pregnant women in the second and third trimesters of pregnancy, as well as the prognostic significance of MS in assessing the course and outcome of pregnancy. Materials and Methods: Prospective cohort study included 135 pregnant women after 24 0/₇ weeks of pregnancy, hospitalized in the period from the January 1^st, 2014 until September 30^th, 2014. Data analysis included descriptive and analytical methods. Results: After assessment of possible confounding effect of age the authors confirmed that women with MS were 1,685-fold more likely give birth by caesarean section (OR = 1.685, p = 0.048), that it was a statistically significant prognostic factor in the earlier weeks of delivery (p = 0.001), and that it was statistically significant prognostic factor of lower Apgar scores in infants (p = 0.003). Conclusion: The early detection of MS during pregnancy reduces perinatal morbidity and is an important factor for the pregnancy outcome.