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

摘要： 目的　分析北京市朝阳区高危妊娠情况并探讨干预措施，为有效降低孕产妇及围生儿病死率提供科学依据。方法　收集2013—2016年朝阳区基层卫生服务机构上报的《孕产妇保健健康情况年报》《孕产妇保健情况调查表率表》及北京市妇幼保健网络信息系统的《北京市围产保健管理登记册》孕产妇个案信息，将其分为高危孕产妇组及对照组（正常孕产妇），收集高危孕产妇管理情况、产检情况、高危因素情况、分娩结局、孕产妇死亡情况。结果　2013—2016年朝阳区孕产妇共141 702例，高危孕产妇85 544例（60.37%），高危孕产妇管理人数85 452例（99.89%）；高危孕产妇《北京市母子健康档案》建立时间：在孕l3周前68 009例（79.50%），孕13~27周13 434例（15.70%），孕28周后4 101例（4.80%）。未产检的高危孕产妇逐年减少，产检>5次的孕产妇逐年增加；高危孕产妇组死胎死产发生率、早期新生儿病死率均高于对照组（P<0.05）；2013年高龄、巨大儿、流产≥2次位居高危因素的前3位，2014—2016年高龄、瘢痕子宫、糖代谢异常/糖尿病位居高危因素的前3位；6例孕产妇死亡中，5例孕产妇在妊娠期间具有不同的高危因素。结论　高危孕产妇逐年增加，而产检>5次的孕产妇也逐年增加，因此通过严格筛查，实行孕产妇全覆盖管理，加强围生期监护，提高孕期保健及监测质量，有效、充分发挥社区卫生服务机构-区妇幼保健机构-各助产机构全程动态三级管理模式的功能，提高产科质量，降低高危妊娠的发生率，从而降低孕产妇、围生儿病死率。

关键词: 妊娠, 高危, 产前保健, 早期医疗干预, 北京