关键词: 妊娠, 高危, 产前保健, 早期医疗干预, 北京

Abstract: Objective　To investigate the status of high-risk pregnancy in Chaoyang District of Beijing，and based on this，to propose corresponding intervention measures，providing a scientific basis for the reduction of maternal and perinatal mortality rates.Methods　From the Annual Report of Maternal Health Care and Rate of Maternal Health Care Survey Questionnaire reported by the grassroots medical institutions in Beijing's Chaoyang District and Beijing Perinatal Health Care Management Register of Beijing Maternal and Child Health Network Information System，we collected the data about pregnant and lying-in women〔including high-risk pregnant and lying-in women（high-risk group） normal pregnant women（control group）〕 during 2013—2016.We analyzed the high-risk group's management，antenatal care status，high-risk factors，delivery mode，delivery outcome，and maternal mortality status.Results　From 2013 to 2016，the total number of pregnant women was 141 702，and that of high-risk lying-in women was 85 544（60.37%），high-risk management population 85 452（99.89%）．Beijing Maternal and Child Health Records were established before the 13th gestational week for 68 009（79.50%） high-risk pregnant and lying-in women，between the 13th and 27th gestational weeks for 13 434（15.70%） high-risk pregnant and lying-in women，and after the 28th gestational week for 4 101（4.80%） high-risk pregnant and lying-in women.The number of women who are at high risk of not having a birth test decreases year by year， while the number of pregnant women who have had >5 birth examinations increases year by year.Compared with the control group，high-risk group presented higher rates of dead-fetus/stillbirth and early neonatal mortality（P<0.05）．The 3 leading risk factors for high-risk pregnancy and lying-in women in 2013：advanced age，macrosomia，and 2 or more times of abortion.The 3 leading risk factors for high-risk pregnancy and lying-in women during 2014—2016：advanced age，scarred uterus，abnormal glucose metabolism/diabetes.Of the 6 dead pregnant and lying-in women，5 were found with different risk factors for high-risk pregnancy.Conclusion　The number of high-risk pregnant women increases year by year，while the number of pregnant women who >5 birth examinations increases year by year.In order to reduce the maternal and perinatal mortality rates，the incidence of high-risk pregnancy should be decreased by strictly prenatal screening the risk factors for high-risk pregnancy，enhancing the health care and monitoring quality during pregnancy via strengthening the full coverage of the management of pregnant and lying-in women and perinatal monitoring，giving full play to the role of the three-tier dynamic management pattern（community health service organization-district-level maternal and child health care institution-midwifery institution） and advancing the obstetric care quality.

Key words: Pregnancy, high-risk；Prenatal care；Early medical intervention；Beijing