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Related Experiment Videos

Grandmultiparae in a modern setting.

G J Bugg1, G S Atwal, M Maresh

  • 1St Mary's Hospital, Manchester, UK.

BJOG : an International Journal of Obstetrics and Gynaecology
|April 13, 2002
PubMed
Summary
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Grand multiparity, defined as five or more previous deliveries, does not appear to increase intrapartum complications. Risk assessment in pregnancy should focus on individual history rather than parity alone.

Area of Science:

  • Obstetrics and Gynecology
  • Maternal-Fetal Medicine
  • Reproductive Health

Background:

  • Grand multiparity (five or more previous deliveries) has historically been associated with increased obstetric risks.
  • Current clinical practice often stratifies risk based on parity, but evidence for grand multiparity's impact on complications needs re-evaluation in developed healthcare settings.

Purpose of the Study:

  • To compare the incidence of antenatal and intrapartum complications and neonatal outcomes between grandmultiparous women and age-matched multiparous women (two to three previous deliveries).
  • To determine if grand multiparity itself is an independent risk factor for adverse pregnancy outcomes.

Main Methods:

  • A matched cohort study was conducted, comparing 397 grandmultiparous women with 397 age-matched multiparous women.

Related Experiment Videos

  • Data were extracted from a UK university maternity hospital's computerised maternity information system (SMMIS).
  • Data accuracy was validated against a 10% sample of casenotes, with high agreement (>95% for most fields, Cohen's kappa >0.6 for categorical variables).

    • Main Results:

    • The overall incidence of intrapartum complications was similar between groups (16% in grandmultiparous vs. 18% in multiparous women).
    • Grand multiparity was associated with higher body mass index and increased antenatal anemia (22% vs. 16%).
    • Elective cesarean section rates were lower in grandmultiparous women (6% vs. 11%).

    Conclusions:

    • In developed countries with adequate healthcare, grand multiparity is not inherently dangerous and does not significantly increase intrapartum complications.
    • Pregnancy risk assessment should prioritize individual patient history and current conditions over simply the number of previous deliveries.