Background
A pregnancy risk score system in popular use in provincial and rural Queensland to assist with the triage decisions regarding the appropriate facility for pregnancy care has been upgraded with more recently recognised pregnancy risk factors.

Aims
To review the usefulness of the revised pregnancy risk score system and the integrity of its continuing use.

Materials and Methods
459 women attending regional/rural hospitals and 1963 women attending a major specialist hospital for their pregnancy care had a prospective risk score assessed, and the resulting score was examined in relationship to pregnancy outcomes.

Results
There was a statistically significant positive relationship between a risk score of eight or more and an adverse outcome and a statistically significant negative relationship between a risk score of zero or one and adverse outcomes.

Conclusion
This study revalidates the risk score process for use in provincial and rural Queensland in delineating those women requiring care in a location with higher levels of clinical service capability. Women with a risk score of 8 or more have an increased likelihood of needing birth intervention and/or having an adverse neonatal outcome and should be recognised as needing the development of a multidisciplinary care plan and assessment in a facility that is appropriately resourced for their end of pregnancy care.