Objective To analyze the pregnancy risk of high-risk pregnant women in Qiandongnan Prefecture from 2018 to 2022.Methods The high-risk pregnant women in Qiandongnan Prefecture from 2018 to 2022 were retrospectively selected,and the distribution of pregnancy risk grade was analyzed.Results From 2018 to 2022,the proportion of green and yellow pregnant women was the highest,and the proportion of orange pregnant women increased from 2020 to 2022.The main risk factors of purple alert for high-risk pregnant women in Qiandongnan Prefecture were viral hepatitis,accounting for more than 70%each year,syphilis accounting for more than 18%each year,and human immunodeficiency virus infection,acquired immune deficiency syndrome,tuberculosis and other risk factors accounted for relatively less.Conclusion In order to ensure the safety of mother and child,it is necessary to strengthen the monitoring and management of high-risk pregnant women and improve the accuracy and timeliness of pregnancy risk assessment.