Grand multiparity as an obstetric risk factor; a prospective case-control study

Area of Science:

• Obstetrics and Gynecology
• Maternal-Fetal Medicine
• Perinatal Research

Background:

• Grand multiparity, defined as five or more deliveries, is a demographic factor that warrants investigation for potential obstetric risks.
• Previous research has explored associations between high parity and adverse pregnancy outcomes, necessitating further clarification in well-resourced settings.

Purpose of the Study:

• To prospectively compare pregnancy, delivery, and neonatal outcomes between grand multiparous women and a control group.
• To identify specific clinical differences and assess their impact on maternal and neonatal health in a socio-economically stable environment with free medical access.

Main Methods:

• A prospective comparative study involving 480 grand multiparous women and 325 controls.
• Collection and analysis of data on pregnancy parameters, delivery interventions, and neonatal outcomes.
• Statistical comparison of clinical differences, including blood pressure, episiotomy rates, and placental complication frequencies.

Main Results:

• Grand multiparas exhibited a slightly higher mean diastolic blood pressure (79.8 vs. 77.8 mmHg) and significantly lower episiotomy rates (5.8% vs. 45.7%).
• A statistically significant increase in placental complications (placenta previa, abruptio, and retention) was observed in grand multiparas (3.4% vs. 0.9%, P < 0.05).
• No significant differences in neonatal outcomes were found between the groups.

Conclusions:

• Grand multiparity is associated with an increased incidence of placental complications, classifying it as an obstetrical risk factor.
• Despite the elevated risk of placental issues, good obstetric care ensures no adverse effects on maternal or neonatal outcomes.
• The findings underscore the importance of vigilant monitoring for placental complications in grand multiparous women, even within supportive healthcare systems.