A simplified, numerical form for antepartum risk scoring was introduced as a component of the prenatal record for use in all pregnancies in a large geographic area under a variety of collection practices. In a population of .apprx. 1,000,000 with 16,733 deliveries, 19% of the pregnant population scored .gtoreq. 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 = < 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. The risk scoring system may have 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.