Grand multiparity: is it still a risk in pregnancy?

Authors

Andrew H. Mgaya, Muhimbili National Hospital, Dar es salaam
Siriel N. Massawe, Muhimbili University of Health and Allied Sciences, Dar es salaam
Hussein Kidanto, Aga Khan UniversityFollow
Hans N. Mgaya, Muhimbili University of Health and Allied Sciences, Dar es salaam

Document Type

Article

Department

Obstetrics and Gynaecology (East Africa)

Abstract

Background The 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.

Methods A 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.

Results Grand 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.

Conclusion Grand 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.

Comments

This work was published before the author joined Aga Khan University.

Publication (Name of Journal)

BMC Pregnancy and Childbirth

Recommended Citation

Mgaya, A. H., Massawe, S. N., Kidanto, H. L., & Mgaya, H. N. (2013). Grand multiparity: is it still a risk in pregnancy?. BMC pregnancy and childbirth, 13(1), 1-8.

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.