Abstract： Objective To investigate the relationship between the classification of early onset secere preeclampsia and perinatal outcomes. Methods 80 patients with S-PE were divided into two groups;Early onset of S-PE (group A) 14 cases (onset≤ 34 weeks) and late onset of S-PE (group B) 66 cases (onset ＞34 weeks). The clinical data,complications,perinatal outcome and placental inhibin A,placenta activin A were compared. Results Among 80 cases with S-PE, 14 cases(17.5% ) in group A were significantly lower than the 66 cases(82.5% ) in group B( x2 = 3.989, P ＜ 0.05) ;The complication rate of 14 cases (100. 0% ) in group A were significantly higher than 18 cases (27. 3% ) in group B(x2 =3.989,P＜0.05) ;The perinatal survival rate of 27.3% in group A was significantly lower than 79.3% in group B(x2 = 3.789,P＜0. 01) ;The expression of placental inhibin A and placenta activin(589. 24 ± 16.96),(485.06 ±17. 58) in group A were significantly higher than (459. 36 ± 13. 05) , (338. 29 ± 11.23) in group B( t - 2.424,2.439, P ＜ 0.05) ; The expression of placental inhibin A and placenta activin with 24h urine protein(24h) were positively correlated(r = 0.62,0.59,all P＜0.05). Conclusion Early onset with S-PE were attacked abruptly and serious complications. It was significantly associated with poor maternal and perinatal outcomes.