The determination of high-risk pregnancy: the use of antenatal scoring system

A standardized antenatal scoring system is not available in order to detect high-risk pregnancies at primary health care units in Turkey. The authors aimed to evaluate the applicability of the "Knox scoring system" in Turkey.

One hundred and twenty-nine pregnant women were included in study. They were assessed upon admission and then the same women were reassessed at the onset of labor by Knox scoring system.

The Knox scoring system identified 65 pregnant women (50.4%) as high-risk upon admission while 22 pregnant women (17.1%) as high-risk at the onset of labor. Twelve pregnant women (9.3%) (one case of perinatal death and 11 cases of perinatal morbidity) had poor perinatal outcomes during the study period. The Knox scoring form administered upon admission yielded 58% sensitivity, 50% specificity, and 10% positive predictive value, while 91% sensitivity, 90% specificity, and 50% positive predictive value at the onset of labor. The diagnostic value of the Knox scoring system for determining high-risk pregnancies was not found statistically significant regarding admission (ROC value: 0.655; p > 0.05), while statistically significant regarding the onset of labor (ROC value: 0.946; p < 0.05).

The use of the Knox scoring system for determining high-risk pregnancies seems to be effective at the onset of labor.