Risk Scoring in Pregnancy and Maternal and Perinatal Outcomes: A Prospective Observational Study from a Tertiary Care Institute in South India.

Introduction: High-risk pregnancies refer to conditions that pose significant health risks to the mother, the foetus, or both. These pregnancies are linked to a higher incidence of maternal complications, such as antepartum haemorrhage, postpartum haemorrhage, infections, and an increased need for operative deliveries. Additionally, infants born to high-risk mothers have an increased likelihood of low birth weight, preterm birth, respiratory distress, and a higher risk of neonatal mortality. Materials and Methods: This hospital-based prospective observational study was conducted in the Department of Obstetrics and Gynecology at AIIMS Mangalagiri, a tertiary carte institute in South India over a period of two years from January 2023 to January 2025 after obtaining IEC approval. A total of 432 pregnant women were enrolled in study. Each participant was stratified into low, moderate, or high-risk categories using a risk scoring system. The maternal and foetal outcomes of each group were analysed. Results: Among the 432 participants, 97 (22.5%) were classified as high-risk. Higher Coopland's scores were significantly associated with unfavourable maternal outcomes, including increased hospitalizations, labour inductions, operative deliveries, and intrapartum complications such as prolonged or difficult labour. The high-risk group also experienced a significantly higher incidence of postpartum haemorrhage, puerperal fever, and extended hospital stays. Additionally, adverse foetal outcomes, including preterm birth, low birth weight, low APGAR scores, the need for neonatal resuscitation, NICU admission, and prolonged NICU stays, were significantly more frequent in this group. Conclusion: The high-risk group constituted 97 (22.5%) of pregnant women delivering at our institute, as determined by the risk scoring system. Higher risk scores were significantly associated with adverse maternal and perinatal outcomes, including complications during labour, postpartum, and neonatal care. The early detection of high-risk pregnancies using reliable risk assessment tools enables timely interventions and specialized care, ultimately enhancing the health and well-being of both mother and baby. This study highlights the significance of integrating risk evaluation methods into routine prenatal care to achieve better pregnancy outcomes.