Abstract We conducted a descriptive study to determine the relationship between prenatal risk and birth outcomes in the antepartal caseloads of rural public health nurses. A convenience sample of 41 low-income pregnant women was assessed for prenatal risk by the nurses at the time of admission and again after 32 weeks' gestation. Birth outcome data were collected from maternal and infant hospital medical records. Analysis of the difference in mean scores from the first to the second assessment indicated a statistically significant change in the prenatal psychosocial risk score (P= 0.000) after public health nursing care. Physiologic and psychosocial risks at both assessment points were related to only one infant outcome measure: the 5-minute Apgar score. Psychosocial risk in late pregnancy accounted for 22% of the variance in 5-minute Apgar scores.