Grand multiparity: is it still a risk in pregnancy?

Abstract

BackgroundThe association of grand multiparity and poor pregnancy outcome has not been consistent for decades. Classifying grand multiparous women as a high-risk group without clear evidence of a consistent association with adverse outcomes can lead to socioeconomic burdens to the mother, family and health systems. We compared the maternal and perinatal complications among grand multiparous and other multiparous women in Dar es Salaam in Tanzania.MethodsA cross-sectional study was undertaken at Muhimbili National Hospital (MNH). A standard questionnaire enquired the following variables: demographic characteristics, antenatal profile and detected obstetric risk factors as well as maternal and neonatal risk factors. Predictors of adverse outcomes in relation to grand multiparous women were assessed at p = 0.05.ResultsGrand multiparas had twice the likelihood of malpresentation and a threefold higher prevalence of meconium-stained liquor and placenta previa compared with lower-parity women even when adjusted for age. Neonates delivered by grand multiparous women (12.1%) were at three-time greater risk of a low Apgar score compared with lower-parity women (5.4%) (odds ratio (OR), 2.9; 95% confidence interval (CI), 1.5–5.0). Grand multiparity and low birth weight were independently associated with a low Apgar score (OR, 2.4; 95%, CI 1.4–4.2 for GM; OR, 4.2; 95% CI, 2.3–7.8) for low birth weight.ConclusionGrand multiparity remains a risk in pregnancy and is associated with an increased prevalence of maternal and neonatal complications (malpresentation, meconium-stained liquor, placenta previa and a low Apgar score) compared with other multiparous women who delivered at Muhimbili National Hospital.

Factors Associated with Low Birth Weight Babies Delivered in Comprehensive Health Centre, Gindiri, North Central Nigeria

“…17 Mother's parity was recorded from discrete variable into categorical variable as primiparous, multiparous and grand multiparous. 18 The haematocrit level was re-coded as anaemia (PCV less than 33%) and normal Haematocrit (PCV ≥ 33%) according to WHO criteria, 19 also the height of the mothers was re-coded as normal stature (155cm and above) and short stature (154cm and below). 17,20 The outcome variable, birth weight, was transformed from continuous variable to a binary variable using 2.5kg as the cut-off point.…”

Rates of Deliveries with Vacuum Extraction and the Relationship Between Maternal Age, Parity and Neonatal APGAR Scores

“…Higher number of parity is a well known parameter which is associated with low APGAR scores and poor neonatal outcomes (19)(20)(21) . But there is still a lack of data about the relationship between parity and neonatal outcomes related to vacuum-assisted deliveries.…”

Grandmultiparity: The Reasons Women Give for High Parity in South-South Nigeria

“…The total fertility rate; the estimated number of births over a woman's lifetime slightly rose to 1,862.5 births per 1,000 women by 2014 in USA [10]. The contrary is true in the poorer nations like sub-Saharan African countries Nigeria inclusive with rates more than 5 children per woman [1]. Rates higher than two children indicate a population growing in size with a declining median age.…”

“…There has been extensive study with reports in the literature on increased adverse obstetric outcomes in high party [1,15]. Proportionally high rates of maternal death among grandmultipara have been reported from centers in Nigeria [2][3].…”

“…High parity is globally one of the implicated risk factors for increased maternal and perinatal morbidity and mortality [1]. In Nigerian literatures, grandmultiparity contributes 35-38.4% of maternal deaths [2][3].…”