Published: 2021-03-24

High risk scoring in pregnancy using modified Coopland’s scoring system and its association with perinatal outcome

Shobha S. Pillai, Swapna Mohan


Background: High-risk pregnancy is one in which the mother, foetus or the newborn has an elevated risk of experiencing an adverse outcome. These high-risk women form a special vulnerable cohort that can be identified in the antenatal period using a simple, easy to use, cost-effective tool- a maternal risk scoring system. Early identification of these high-risk mothers will facilitate effective intervention strategies to deal with the complications.

Methods: This study was carried out on 300 pregnant women with gestational age more than 28 weeks. Detailed history, examination and necessary investigations were done and then using the Modified Coopland scoring system, each pregnant woman was assigned a risk score and stratified into 3 risk groups- low risk (0-3), moderate risk (4-6) and high risk (≥7) and followed up till delivery and 7 days postpartum. Subsequently, the maternal and perinatal outcomes were compared with their respective scores.

Results: In this study, 14.66% patients belonged to the high-risk category. Statistically, a significant difference was noted in the number of low-birth-weight babies, in 5 minutes APGAR score <7 and in NICU admissions in the high-risk group compared to the low-risk group. Overall perinatal mortality was 13.33/1000 live births. In the high-risk group, a significant difference was seen in the occurrence of PPH and the need for operative delivery.

Conclusions: Significant association between high-risk pregnancy and the poor maternal and perinatal outcome was noted. Therefore, a simple, cost-effective high-risk pregnancy scoring system such as the one proposed in this study can be used to identify potential high-risk pregnancies, provide them with tertiary care facilities and also corrective measures can be undertaken to prevent or minimize the complicating factors.


Birth asphyxia, High risk pregnancy, Low birth weight, Maternal mortality, Maternal risk score, Perinatal mortality, Preterm birth,

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