Abstract: Objective: To establish a multi-factor model of heart disease patients with heart failure during pregnancy and analyze the influence of heart failure on pregnancy outcome.Methods: A total of 148 patients with heart disease during pregnancy admitted to the Department of Obstetrics of Shaanxi Provincial People's Hospital from January 2021 to December 2022 were collected as the research objects.The pregnant patients were followed up until the delivery, and the occurrence of heart failure was counted.They were divided into heart failure group(n=56) and simple heart disease group (n=92).The clinical data of the two groups were compared, a multivariate logistic regression model of heart disease patients with heart failure during pregnancy was constructed, the influencing factors of heart failure in patients with heart disease during pregnancy were explored, and the receiver operating characteristic (ROC) curve was drawn to verify the influence of the above factors on heart failure.Results: The incidence of pregnancy-induced hypertension, anemia, hypoproteinemia and pulmonary hypertension in the heart failure group was higher than that in the simple heart disease group, and the level of brain natriuretic peptide(BNP)was higher than that in the simple heart disease group(P< 0.05).Logistic regression model results showed that pregnancy-induced hypertension, anemia, hypoproteinemia, pulmonary hypertension and high BNP levels were the risk factors for heart failure in patients with heart disease during pregnancy (OR=72.644, 4.871, 43.693, 30.391, 1.024, P< 0.05).The result of ROC curve showed that AUC was 0.934, and the model was reliable and stable.The cesarean section rate and postpartum hemorrhage rate in the heart failure group were higher than those in the simple heart disease group, and the Apgar score of newborn was lower than that in the simple heart disease group (P< 0.05).Conclusion: The occurrence of heart failure in patients with heart disease during pregnancy may be related to pregnancy-induced hypertension, anemia, hypoproteinemia, pulmonary hypertension and high BNP levels.The established logistic regression model can predict the possibility of heart failure in patients with heart disease during pregnancy.