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High parity and adverse birth outcomes: exploring the maze
Muktar H Aliyu1, Pauline E Jolly, John E Ehiri
1Department of Epidemiology, University of Alabama at Birmingham School of Public Health, Birmingham, Alabama, USA.
Birth (Berkeley, Calif.)
|February 24, 2005
Summary
High parity (many pregnancies) may increase risks for certain medical complications and fetal macrosomia. Evidence for adverse birth outcomes in grand multiparity is inconsistent, but extreme parity warrants attention.
Area of Science:
- Obstetrics and Gynecology
- Reproductive Health
- Perinatal Medicine
Background:
- The association between high parity and adverse birth outcomes remains uncertain.
- Grand multiparity (>=5 births) and great grand multiparity (>=10 births) require critical evaluation.
- Existing literature presents conflicting evidence on risks in high-parity women.
Purpose of the Study:
- To critically evaluate evidence for and against adverse maternal and/or fetal outcomes in high parity.
- To clarify the risks associated with grand and great grand multiparity.
Main Methods:
- Conducted an electronic literature search of major bibliographic databases.
- Retrieved and analyzed relevant English-language articles.
Main Results:
- Findings on high parity and maternal-fetal outcomes are inconsistent.
- Older literature suggested risks, while recent studies are less supportive.
- Confounding factors (age, SES, prenatal care) and study variations complicate comparisons.
Conclusions:
- Preponderance of evidence suggests heightened risk for medical complications and placental pathologies in extreme parity.
- Reasonable evidence indicates a higher likelihood of fetal macrosomia with advanced parity.