Objective To investigate the risk factors for staying in the intensive care unit（ICU） for more than 48 hours in pregnant and parturient women，and to identify related predictive indicators. Methods A total of 146 critically ill pregnant women or parturient women （within 42 days after delivery） who were admitted to the ICU of Women and Children’s Hospital of Chongqing Medical University from January to December 2023 were enrolled in this study. According to the length of stay in the ICU，the pregnant and parturient women were divided into short-term（≤48 hours） group with 60 women and long-term （>48 hours） group with 86 women. Related data were recorded and analyzed，including general information，pregnancy characteristics，ICU interventions，vital signs，and laboratory parameters. The receiver operating characteristic（ROC） curve was used to assess the value of these indicators in predicting the length of stay in the ICU for more than 48 hours in pregnant and parturient women. Results Compared with the short-term group，the long-term group had a significant increase in the proportion of women receiving mechanical ventilation（P=0.001），radiological examination（P=0.022），antihypertensive pharmacotherapy（P=0.001），diuretic pharmacotherapy（P=0.001），antibiotic therapy（P=0.006），and blood transfusion for >5 U（P=0.032）. Compared with the short-term group，the long-term group had a significantly lower number of prenatal visits（P=0.003） and a significantly higher body mass index on admission to the ICU（P=0.012）. The long-term group had a significantly higher number of pregnant and parturient women with hypertensive disorders in pregnancy compared with the short-term group （P=0.016）. In addition，the long-term group had a significantly higher level of blood pressure than the short-term group（P=0.001），and there were significant differences between the two groups in albumin，alanine aminotransferase，direct bilirubin，24-hour urine protein，and serum creatinine（P<0.05）. The ROC analysis showed that systolic blood pressure，diastolic blood pressure，and mean arterial pressure had a relatively high value in predicting the length of stay in the ICU for more than 48 hours in pregnant and parturient women，with an area under the ROC curve of 0.825，0.782，and 0.811，respectively. The length of stay in the ICU was further prolonged for the pregnant and parturient women with a lower number of prenatal visits and hypertensive disorders in pregnancy（P<0.05）. Conclusion Hypertensive disorders in pregnancy are an important risk factor for prolonged stay in the ICU，which can provide certain ideas for the critical care management of pregnant and parturient women.