PIP: During September 1989-December 1990 in India, clinicians included every fifth pregnant woman attending the prenatal clinic of New Civil Hospital in Ahmedabad with amenorrhea no greater than 12 weeks in a longitudinal study of scoring of high-risk pregnant women and their pregnancy outcomes. They used the ICMR risk scoring system to score the 900 women during their first and second visits, during their second and third trimesters, and when admitted for delivery. The clinicians were able to follow up on only 687 women. 81.66% had high risk factors. The higher the risk score, the less likely the women had a normal delivery (0 score = 96.03%, 1-3 = 79.14%, 4-6 = 61.87%, =or 7 = 40%; p 0.0001). 40% of women in the most severe risk group had an instrumental delivery compared to only 3.17% for those with no risks (p 0.0001). The incidence of premature birth was significantly higher among women with a risk score greater than zero than among those with no risk factors (95.77% vs. 2.38%; p 0.001). Women with no risk factors had no stillbirths, while 20% of those in the highest risk group did. 16.3% of mothers had at least one postnatal complication. Postnatal complications increased with the risk level (6.35% for 0; 15.59% for 1-3, 26.62% for 4-6, and 40% for =or 7). The only maternal death occurred in a woman with a risk score of 4-6. The maternal mortality rate was 1.46/1000 live births. These findings indicate a need for proper and timely prenatal care, improving general hygiene in labor rooms, washing hands before and after dressing women who undergo obstetrical surgery, and perineal support during delivery.