Obstetric complications and neonatal outcome of grandmultiparity: A comparative study

Mohamed Alkhatim Alsammani, Salah Roshdy Ahmed

Abstract


Background: The aim of the current study was to determine the prevalence of grand multiparity and the associated risks factors.  

Methods: Four hundred thirty grand mutliparas (parity 5 or more) were compared with multiparous population (parity 2-4) with regard to maternal age, gestational age, mode of delivery, fetal and maternal outcomes and inter-current medical and obstetrical problems.

Results: There were significant association between grand multiparity and adverse pregnancy outcomes such as cesarean delivery (OR=2.699, CI=2.072-3.515, P <0.001), fetal macrosomia (OR=1.675; 95% CI=1.004-2.796, P = 0.048), diabetes mellitus (OR=1.634, 95%CI=1.076-2.481, P = 0.021), and pregnancy induced hypertension (OR=1.838, 95% CI=1.054-3.204, P = 0.032). No significant associations were seen in placenta abruption, placenta previa, preterm labor, postpartum hemorrhage and the frequency of admission to neonatal intensive care unit. No prenatal or maternal mortality was reported in this study.

Conclusions: Grand multiparity remains a major obstetrics problem. It is associated with many medical and obstetrical complications. In communities where large family is desirable it is important to address the value of family planning and conduction of meticulous antenatal care.

Keywords


Grand multiparity, Pregnancy outcome, Obstetric complications, Neonatal morbidity

Full Text:

PDF

References


Al JF. Grand multiparity: a potential risk factor for adverse pregnancy outcomes. J Reprod Med. 2012 Jan-Feb;57(1-2):53-7.

Kumari AS, Badrinath P. Extreme grand multiparity: is it an obstetric risk factor? Eur J Obstet Gynecol Reprod Biol. 2002 Feb;101(1):22-5.

Kaplan B, Harel L, Neri A, Rabinerson D, Goldman GA, Chayen B. Great grand multiparity--beyond the 10th delivery. Int J Gynecol Obstet. 1995 Jul;50(1):17-9.

Trading Economics. Fertility rate - total (births per woman) in Saudi Arabia, 2014. Available at: http://www.tradingeconomics.com/saudi-arabia/fertility-rate-total-births-per-woman- wb-data.html.

Shahida SM, Islam MA, Begum S, Hossain MA, Azam MS. Maternal outcome of grand multipara. Mymensingh Med J. 2011 Jul;20(3):381-5.

Evaldson GR. The grand multipara in modern obstetrics. Gynecol Obstet Invest. 1990;30(4):217-23.

Akwuruoha E, Kamanu C, Onwere S, Chigbu B, Aluka C, Umezuruike C. Grand multiparity and pregnancy outcome in Aba, Nigeria: a case-control study. Arch Gynecol Obstet. 2011 Feb;283(2):167-72.

Duria A. Rayis, Abdel Aziem A. Ali, Ameer O. Abbaker, Ishag Adam. Maternal and perinatal outcomes of grand multiparity in Kassala hospital, eastern Sudan. Khartoum Med J. 2011;04(01):554-7.

Jabbar FA, Wong SS, Al-Meshari AA. Practice and methods of contraception among Saudi women in Riyadh. Fam Pract. 1988 Jun;5(2):126-8.

Nordin NM, Fen CK, Isa S, Symonds EM. Is grand multiparity a significant risk factor in this new millennium? Malays J Med Sci. 2006 Jul;13(2):52-60.

Kumari AS, Badrinath P. Extreme grand multiparity: is it an obstetric risk factor? Eur J Obstet Gynecol Reprod Biol. 2002 Feb;101(1):22-5.

Samueloff A, Schimmel MS, Eidelman AI. Grandmultiparity. Is it a perinatal risk?.Clin Perinatol. 1998 Sep;25(3):529-38.

Goldman GA, Kaplan B, Neri A, Hecht-Resnick R, Harel L, Ovadia J. The grand multipara. Eur J Obstet Gynecol Reprod Biol. 1995 Aug;61(2):105-9.

Yasmeen S, Danielsen B, Moshesh M, Gilbert WM. Is grand multiparity an independent risk factor for adverse perinatal outcomes? J Matern Fetal Neonatal Med. 2005 Apr;17(4):277-80.

Rayamajhi R, Thapa M, Pande S. The challenge of grand multiparity in obstetric practice. Kathmandu Univ Med J (KUMJ). 2006 Jan-Mar;4(1):70-4.

Akwuruoha E, Kamanu C, Onwere S, Chigbu B, Aluka C, Umezuruike C. Grand multiparity and pregnancy outcome in Aba, Nigeria: a case-control study. Arch Gynecol Obstet. 2011 Feb;283(2):167-72.

Abasiattai AM, Utuk NM, Udoma EJ, Umoh AV. Grand multiparity: outcome of delivery in a tertiary hospital in southern Nigeria. Niger J Med. 2011 Jul-Sep;20(3):345-8.

Donald I. The grand multipara. In: Donald I, eds. Practical Obstetrical Problems. 5th ed. London: LIoyd Luke Ltd; 1988: 138-141.

Nassar AH, Fayyumy R, Saab W, Mehio G, Usta IM. Grand multiparas in modern obstetrics. Am J Perinatol. 2006;23:345-9.

Rayamajhi R, Thapa M, Pande S. The challenge of grand multiparity in obstetric practice. Kathmandu Univ Med J (KUMJ). 2006;4:70-4.

Ahmadi S, Nouira M, Bibi M, Boughuizane S, Saidi H, Chaib A, et al. Uterine rupture of the unscarred uterus. About 28 cases. Gynecol Obstet Fertil. 2003 Sep;31(9):713-7.