Objective To understand the current situation of risk factor discovery of high-risk infants in pilot areas of high-risk child management projects in 12 provinces of China

and to provide reference for promoting high-risk child management services in all the regions. Method From the 48 districts/counties maternal and child health care institutions in 12provinces the high risk children were found in the fourth quarter of 2020 and were investigated using the Risk Classification Screening Form for High-risk Children to compare the detection of four types of high-risk factors in different regions.Results 9792 cases（21.58%） of high-risk children were found in the fourth quarter of monitoring in 48 pilot districts/counties. Among them

24.71%

12.70%

and 23.10% were found in the east

the middle central

and the west

and 16.98% and 27.22% in urban and rural areas

respectively. Among the risk factors included in the management of high-risk child

the detection rates of individual biological factors and family biological factors were 14.08% and 10.11%

respectively

while the detection rates of family environmental factors were only 0.01%. There was a significant difference in the detection rates of most high-risk factors in different regions（P<0.05）

showing a higher trend in the east than in the west than in the central part.According to the requirements of grading and classification management of high-risk child

the total referral rate of high-risk children found in pilot areas was 54.37%

including 64.43% at district and county levels and 2.27% at municipal institutions or above. Conclusion The results of the pilot project suggest that children with high-risk factors account for a certain proportion of the population

and it is necessary to formulate policies to carry out public health management. There are differences in the detection rates of high-risk infants between different regions and urban and rural areas

and the detection ability of different types of risk factors is different. It is recommended to improve and strengthen the detection and management of the key areas and key types through training and other forms

and develop referral strategies in accordance with local conditions.