Objective To investigate the impact of distinct socioeconomic status (SES) patterns on the risk of thyroid diseases in pregnant women against the background of adequate iodine nutrition. Methods A cross-sectional study was conducted in Xinjiang from 2021 to 2022, enrolling 1,166 pregnant women. Fasting venous blood and urine samples were collected to assess thyroid function and iodine nutritional indicators. Long-term and short-term iodine intake were evaluated using a food frequency questionnai