Objective：This study aims to investigate the pregnancy outcome of pregnant women with moderate and severe thrombocytopenia in perinatal pregnancy. Methods：the clinical data of 214 pregnant women with thrombocytopenia who delivered in the obstetrics department of the First Affiliated Hospital of Nanjing Medical University from January 2016 to December 2020 were analyzed retrospectively. They were devided into mild thrombocytopenia group（158 cases） and the pregnancy with moderate to severe thrombocytopenia group（56 cases）. Results：There was no significant difference in body mass index，pregnancy times，labor times and history between the pregnancy with mild thrombocytopenia group and the pregnancy with moderate to severe thrombocytopenia group（P > 0.05）. However，the age of pregnant patients with moderate to severe thrombocytopenia was older（P=0.03），and the gestational week of thrombocytopenia was nearly 7 weeks earlier than that of mild thrombocytopenia group（P < 0.001）. Excluding the influence of delivery mode on intrapartum bleeding，there were no significant differences in intrapartum bleeding between mild thrombocytopenia group and moderate to severe thrombocytopenia group（P > 0.05）. At the same time，the correlation between the severity of thrombocytopenia during pregnancy and postpartum hemorrhage and neonatal outcome was analyzed. There were no significant differences in the severity of thrombocytopenia during pregnancy，postpartum hemorrhage and neonatal outcome between two groups（P > 0.05）. In terms of the changes of coagulation factors before and after delivery，the changes of most coagulation factors in mild thrombocytopenia group were significantly higher than those in moderate to severe thrombocytopenia group（P < 0.05）. Conclusion：Although pregnant women with moderate to severe thrombocytopenia show thrombocytopenia，they should be comprehensively evaluated in combination with other coagulation related indicators，such as thromboelastogram and five coagulation items. Therefore，for pregnant women with thrombocytopenia，especially moderate to severe thrombocytopenia patients，reasonable and effective intervention should be carried out as soon as possible，and the mode of delivery should be selected individually to improve maternal and infant outcomes.