General practitioner obstetrics: does risk prediction work?

The effectiveness of antenatal risk prediction based on maternal characteristics at booking was examined among 5730 pregnant women booked in an integrated general practitioner obstetric unit over a seven-year period. High rates of transfer to consultant care were found especially for nulliparae. Apart from parity, maternal factors associated with transfer before labour were weight, smoking and social class. Factors associated with transfer in labour were maternal stature and marital status. Reasons for transfer were also identified. The validity of the present booking criteria, which were developed in the 1950s, is questioned.