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OBJECTIVE: We sought to evaluate the use of the Ronald McDonald House (RMH) for selected high-risk pregnant women. METHODS: Beginning in November of 1999, women on the Maternal Fetal Medicine service at Albany Medical Center Hospital (AMCH) were candidates for antepartum lodging at the Ronald McDonald House (RMH). Women whose only indication for antepartum hospitalization was to maintain proximity to a tertiary care center were offered stays at the RMH. Antenatal and neonatal outcomes were reviewed. RESULTS: A total of 41 antepartum subjects stayed at the RMH during the study period. No adverse perinatal outcomes were identified due to utilization of the RMH. Patients stayed at the RMH instead of staying at AMCH as inpatients for a total of 586 days during the study period. CONCLUSIONS: Outpatient management at the RMH is a cost-effective alternative for selected high-risk pregnancies. No adverse outcomes in the study population were attributable to the utilization of the RMH. [ABSTRACT FROM AUTHOR]