Objective: The correlation between cognitive emotion regulation strategies and the coping styles and mental health status of pregnant women with high-risk pregnancies was studied to provide a theoretical basis for clinical psychological intervention. Methods: 152 pregnant women with high-risk pregnancies who were hospitalized in the Department of Obstetrics and Gynecology of an A hospital and filed in the outpatient clinic from January 2022 to December 2023 were selected as the observation group, and 150 pregnant women with normal pregnancies who were hospitalized in the Department of Obstetrics and Gynecology and filed in the outpatient clinic during the same period were also selected as the control group. Cognitive emotion regulation questionnaire (CERQ-C), Chinese revised medical coping modes questionnaire (MCMQ), self-assessment of mental health symptoms (symptom-90), and self-assessment of mental health symptoms (MCMQ) were applied to the observation group. CERQ-C, MCMQ, SCL-90 and SCL-90 were used to assess the cognitive-emotional, coping mode and mental health status of the two groups, and to compare the differences in the scores of the scales and their dimensions. Results: The CERQ-C adaptive dimension scores of the observation group were lower than those of the control group, and the non-adaptive dimension scores were higher than those of the control group (P < 0.01); the MCMQ avoidance and submission dimensions scores of the observation group were higher, and the confrontation dimension scores were lower (P < 0.05); and the scores of all symptom dimensions on the SCL-90 of the observation group were significantly higher than those of the control group (P < 0.05). Among the high-risk subgroups, the severe obstetric hemorrhage risk group had the most prominent cognitive-emotional regulation imbalance, negative coping and psychological problems. Pearson correlation analysis showed that adaptive cognitive-emotional regulation was positively correlated with face-to-face coping (r = 0.412, P < 0.01), and non-adaptive cognitive-emotional regulation was significantly positively correlated with yielding coping, anxiety and depression and other psychological symptoms (P < 0.01). Conclusion: Mothers with high-risk pregnancies generally have cognitive emotion dysregulation, mostly adopt non-adaptive emotion regulation strategies, and tend to adopt negative coping styles of avoidance and submission, accompanied by obvious mental health problems, and the psychological stress problems of pregnant women with severe obstetric hemorrhage risk are the most significant. Clinical assessment of the cognitive emotion regulation ability of this group should be emphasized, and precise psychological interventions should be carried out to improve their mental health and pregnancy outcomes.