目的 了解2010—2023年江苏省昆山市产妇生育结构特征及妊娠结局的变化趋势，为采取针对性的政策策略提供依据。方法 以2010—2023年昆山市助产机构上报的围产保健报表、围产儿报表、出生人口性别比报表等为依据，采集所有助产机构上报产妇的社会人口学及围产期结局等指标数据，采用趋势χ2检验分析各项指标的年度变化趋势。结果 2010—2023年昆山市助产机构共统计上报产妇246 266人，高危产妇占比、高龄产妇占比（≥35岁）增长迅速，分别由2010年的29.56%和5.53%上升至2023年的75.70%和18.02%（■，均P<0.01）；生育一孩的产妇占比由70.62%下降至45.81%，生育二孩、三孩及以上的产妇占比由28.45%、0.93%增至44.25%和9.94%（■，均P<0.01）；围产儿死亡率、死胎死产率、早期新生儿死亡率、巨大儿发生率总体呈下降趋势（均P<0.01）；剖宫产率、早产儿发生率、低出生体重儿发生率分别由40.17%、3.97%和3.28%上升至45.21%、5.33%和3.76%（■，均P<0.05）。结论 近14年来，昆山地区生育量增长远期效应乏力，但二孩、三孩及以上的生育占比升高。围产儿死亡率、死胎死产率、早期新生儿死亡率和巨大儿发生率得到有效控制，但在高危孕产妇保健、控制剖宫产率、预防早产等方面仍需实施针对性对策与措施。

Objective To understand the changing trends in the sociodemographic structure characteristics and pregnancy outcomes of parturients in Kunshan city, Jiangsu province from 2010 to 2023 to provide a reference for targeted policy strategies.Methods Based on the perinatal health care reports, perinatal infant reports, and sex ratio reports of the birth population submitted by midwifery institutions from 2010 to 2023, data on indicators of the sociodemographic structure and perinatal outcomes of parturients were collected. The trend χ² test was used to analyze the annual changing trends of each indicator. Results From 2010 to 2023, a total of 246 266 parturients were statistically recorded in Kunshan city. The proportion of high-risk parturients and parturients aged ≥35 increased rapidly, rising from 29.56% and 5.53% to 75.70% and 18.02%, respectively(■, P<0.01).The proportion of parturients giving birth to one child decreased from 70.62% to 45.81%, while the proportion of parturients giving birth to two, three or more children increased from 28.45% and 0.93% to 44.25% and 9.94%, respectively(■,P<0.01). The perinatal mortality rate, stillbirth rate, early neonatal mortality rate, and the incidence of macrosomia generally showed a downward trend(P<0.01). However, the rates of cesarean section, premature infants, and low birth weight infants had been continuously increasing, rising from 40.17%, 3.97% and 3.28% to 45.21%, 5.33% and 3.76%, respectively(■, P<0.05). Conclusion In the past decade or so, the long-term effect of the growth in fertility in Kunshan city has been weak,but the proportion of women giving birth to two, three or more children had increased. The perinatal mortality rate, stillbirth rate, early neonatal mortality rate and the incidence of macrosomia had been effectively controlled. However, targeted countermeasures and measures still need to be implemented in aspects such as health care for elderly/high-risk parturients, controlling the cesarean section rate to enhance fertility protection, and preventing premature birth.