Perinatal mortality and antepartum risk scoring.

A simplified, numerical form for antepartum risk scoring was introduced as a component of the prenatal record for use in all pregancies in a large geographic area under a variety of collection practices. In a population of approximately 1,000,000 with 16,733 deliveries, 19% of the pregnant population scored greater than or equal to 3 and were designated as high risk on the basis of previous pilot studies. This group with high-risk scores had a perinatal mortality rate of 69/1000 compared to the low-risk group with a perinatal mortality of 7/1000 (P = less than 0.0001). The high-risk group accounted for almost 70% of the total perinatal deaths. The implications of being able to predict the statistical likelihood of perinatal deaths are discussed. It is suggested that the risk scoring system has its greatest potential as a screening process and as a method of recording regional statistical trends rather than in dictating the final management of the pregnancy.