Objective To summarize the management of high-risk pregnant women in Yanchi County, Ningxia Hui Autonomous Region from 2011 to 2020 retrospectively, and analyze the problems existing in the process of management, so as to provide evidence for targeted intervention.

Methods All high-risk pregnant women in Yanchi County, Ningxia Hui Autonomous Region management system from 2011 to 2020 were recruited as research subjects. The incidence of high-risk pregnant women, maternal mortality, and perinatal mortality were analyzed. χ² test and trend χ² test were used for comparisons between groups.

Results The rates of hospital delivery, early pregnancy registry, postpartum visit, and system management in Yanchi County, Ningxia Hui Autonomous Region were stable from 2011 to 2020. The system management rate had been maintained at 95.0% - 97.9% in the past 10 years, which all met the national standard (95.0% above). The incidence of high-risk pregnant women showed an upward trend year by year (χ_trend² = 1 283.779, P < 0.001). Perinatal mortality rates pre and post implementation of the "Five Color Management" measure were 12.65‰ and 7.55‰, and the changes were significantly different (χ² = 12.037, P = 0.001).

Conclusion Process and stage management of high-risk pregnant women should be standardized and reinforced, and health education should be emphasized to improve the quality of management, which are the key to reduce the incidence of high-risk pregnant women, maternal mortality rate, and perinatal mortality.