Abstract：Objective To investigate the different etiologies of thrombocytopenia in pregnancy, as well as the clinical characteristics and delivery outcomes corresponding to the severity of thrombocytopenia, so as to provide reference and basis for clinical diagnosis and treatment.  Methods A retrospective analysis was conducted on the clinical data of 205 pregnant women with thrombocytopenia in the Department of Obstetrics at the Second People's Hospital of Anhui Province from January 2020 to March 2025. The patients were divided into GT group, HDCP group, ITP group and other group according to different etiologies, and into mild group, moderate group and severe group according to the severity of thrombocytopenia. General data, time of clinical diagnosis, distribution of the relationship between etiology and severity of thrombocytopenia, clinical characteristics and delivery modes of thrombocytopenia with different etiologies were compared among groups. Results There were statistically significant differences in length of hospital stay among groups（F＝6.86, 13.89, both P＜0.05）. In the mild group and the GT group, the proportion of diagnoses made during the third trimester was the highest. Data on the relationship between etiology and severity showed that the GT group had the highest proportion of mild thrombocytopenia, while the ITP group had the highest proportion of severe cases. The lowest platelet count and postpartum hemorrhage volume were both found in the ITP group. The vaginal delivery rate was the highest in the GT group and mild group, while the cesarean section rate was the highest in the severe group. The above intergroup differences were all statistically significant（χ2＝32.13, 63.43, 63.43, 36.55, 19.53, 7.87, 12.94, 9.68, all P＜0.05）. Conclusion Pregnancy with thrombocytopenia caused by different etiologies has different impacts on the degree of in severity, clinical characteristics and delivery modes. In cases of severe thrombocytopenia, such as ITP, the impact on maternal-fetal outcomes is significant. Timely diagnosis and early intervention are of positive significance for ensuring favorable maternal and infant outcomes.