Grand-multiparity: Is it still an obstetric risk?

Adeola F. Afolabi, Adewale S. Adeyemi

Department of Obstetrics and Gynaecology, College of Health Sciences, Ladoke Akintola University of Technology, Osogbo, Nigeria.

DOI: 10.4236/ojog.2013.34075                

Abstract

Background: Grand-multiparity has been known to be an obstetric risk because of the documented complications associated with the condition, and it is an indication for booking in a tertiary health institution. The increase use of contraceptives and improved health care delivery is expected to reduce both the prevalence and complications of this condition. Aims and Objectives: To determine the prevalence of grandmultiparity, and if it is still associated with the previously documented complications in the obstetric population presenting at Ladoke Akintola University of Technology (LAUTECH) Teaching Hospital, Osogbo. Materials and Methods: A case controlled retrospective study of grand-multiparous women presenting in our institution over a period of ten years. All grandmultiparous women within the study period were identified from the labour ward register, and women with parity 2 - 4 served as control. Statistical analysis was done using SPSS 14. Statistical significance was set at p < 0.05. Logistic regression was done to adjust for confounding variables. Result: There were 5126 deliveries during the study period, and grand-multiparous constituted 128 (2.49%) of these deliveries. Grand-multiparity was found to be associated with pre-labour rupture of membranes, 16.2% versus 4.0% (p = 0.004), hypertensive diseases in pregnancy, 27.1% versus 8.1% (p = 0.001), placenta praevia, 15.3% versus 4.0% (p = 0.007) and other medical illnesses, 23.2% versus 6.1% (p = 0.001). Post-partum haemorrhage, anaemia, puerperal sepsis and urinary tract infections were found to be significantly commoner in the grand-multiparous than in the lower parity group (p < 0.05). After adjusting for confounding variables grand-multiparity was still found to be significantly associated with complications at delivery (OR = 2.70; 95% CI 1.13 - 6.48) and poor fetal outcome (OR = 2.28; 95% CI 1.11 - 4.65). Conclusion: Although the prevalence of grand-multiparity is on the downward trend, it still remained an obstetric risk, therefore, the importance of booking and delivery in a well-equipped facility should be emphasized among the obstetric population so as to reduce the complications that were found to be associated with the condition.

Keywords

Grand-Multiparity; High Risk Pregnancy; Obstetric Outcome

Conflicts of Interest

The authors declare no conflicts of interest.

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