Objective To explore the establishment of an individualized prediction model for the risk of adverse reactions in pregnant women after blood transfusion using column charts.Methods 3 960 pregnant women with blood transfusion records who underwent irregular antibody screening(IAS) before blood transfusion from January 2021 to December 2022 and those who did not undergo IAS before blood transfusion from January 2019 to December 2020 were divided into an occurrence group and a non-occurrence group according to whether adverse reactions such as allergies and hemolysis occurred after blood transfusion. Basic information and clinical data of all patients were retrieved, and logistic regression analysis was used to screen independent risk factors for adverse reactions in pregnant women after blood transfusion. A column chart prediction model was established using R software, and the effect of IAS before blood transfusion on adverse reactions was examined. Results A total of 80 cases (2.02%) experienced adverse reactions to blood transfusion, including 45 cases (1.14%) of allergic reactions, 27 cases(0.68%) of febrile reactions, and 8 cases (0.20%) of delayed hemolytic reactions. Through logistic regression analysis of general clinical data of two groups of patients, it was found that age, history of blood transfusion, frequency of blood transfusion, blood composition, transfusion volume, IAS were independent risk factors for adverse reactions in pregnant women after blood transfusion (P<0.05), all of which were highly correlated to the incidence of adverse reactions. A column chart prediction model was established based on six independent risk factors for BTAR in pregnant women after blood transfusion, including age, transfusion history, transfusion frequency, blood composition, transfusion volume, and IAS. The C-index was as high as 0.850(95% CI: 0.808-0.892), indicating good predictive performance. At the same time, the results also showed that the incidence of BTAR, such as allergies and fever, was significantly reduced in pregnant women who used IAS compared to those who did not use IAS(P<0.05).Conclusion IAS screening should be performed on pregnant women who are elderly, having a history of blood transfusion, a high frequency of blood transfusion, a high blood composition and volume, in order to reduce the risk of adverse reactions after blood transfusion