Grand Multiparity: Obstetric Outcome in Comparison with Multiparous Women in a Developing Country

Abstract

Grand-multiparity is a serious risk factor in pregnancy and common in developing countries. The objective was to compare the obstetric outcome of grand-multiparous women with that of low parity in our center. The study comprised of 150 grand-multiparous women (cases) and 150 multiparous women (para 2 -4) in this index pregnancy as controls matched for age and admitted for delivery. The mean age of the grand-multiparous women at delivery was 37.0 ± 2.8 years. Grand-multiparity was significantly higher among women with only primary education (48.0% versus 44.7%), polygamous marriages (9.3% versus 3.3%) and Muslims (17.3% versus 6.7%). Pregnancy induced hypertension and primary postpartum hemorrhage were significantly more often seen among grand-multiparous women than among the controls. The mean packed cell volume before delivery in the grand-multiparous women was significantly lower (33.6% ± 2.7%) than in the multiparous group (35.2% ± 2.7%) (P-value = 0.000). Grand-multiparity with its associated complications still occurs frequently in our environment. However, with adequate antenatal surveillance, optimal care during labour and contraceptive use, these problems will be reduced.

Maternal and neonatal outcomes of grand multiparity in Khartoum, Sudan

“…A low level of education was associated with grand multiparity in our study. Similar observations of less education amongst grand multiparous women have been reported in other studies 8 , 18 . In Sudan, early marriage might obligate mothers to leave school, especially in rural areas, and hence early marriage leads to both grand multiparity and low education.…”

Effect of Grand Multiparity on the Adverse Birth Outcome: A Hospital-Based Prospective Cohort Study in Sidama Region, Ethiopia

“…Grand multiparity is a condition when a woman has at least five deliveries at gestational age greater than or equal to 20 weeks. 1–3 In many developed countries, grand multiparity is becoming less of a concern with a low prevalence of 2–4% whereas it is still a public health issue of great concern in developing countries and is a high prevalence of 19%. 4–6 …”

“…In different studies conducted in developing countries, adverse perinatal outcomes are significantly associated with grand multiparity compared with multiparity. 1 , 4 , 7 , 10 , 15 , 17–26 The majority of the studies carried out in developing countries, including Ethiopia, implemented incomplete registration of perinatal data with limited variables. There were also limited studies conducted to assess the adverse perinatal outcomes of grand multiparity in Ethiopia.…”

Grand multiparity as a predictor of adverse pregnancy outcome among women who delivered at a tertiary hospital in Northern Tanzania

“…Some literature define it as a woman who delivered four or more times while others consider of six or more deliveries [4]. Furthermore, the International Federation of Gynecology and Obstetrics defined GMP as deliveries of a fifth to ninth, while naming those undergoing their tenth or more deliveries as great grand-multiparous or huge great grand-multiparous [5–8]. According to the CDC report of 2004, the prevalence of grand multiparity was reported as low as 3–4% in developed countries as compared to 19.3% in developing countries, [9, 10].…”