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Grandmultiparity and pregnancy outcome in Aba, Nigeria: a case-control study
E Akwuruoha1, C Kamanu, Stephen Onwere
1Abia State University Teaching Hospital, Aba, Nigeria.
Objective:
To compare the incidence of antenatal and intrapartum complications and perinatal outcomes among women who had delivered five or more times (grandmultiparous) with those of age-matched controls who had delivered two to four times (multiparous).
Design:
A case-control study.
Setting:
A tertiary referral hospital in Aba, Nigeria.
Sample:
Seven hundred and thirty-four grandmultiparous women were compared with 734 age-matched multiparous controls.
Methods:
Maternal case records were retrieved from medical records department and analyzed with additional information obtained from the labor ward records. Statistical analysis was done using EPI info version 6; χ² test was used to analyze categorical variables.
Results:
Grandmultiparity was associated with a significantly higher risk of antenatal anemia (P < 0.05), multiple pregnancy (P < 0.01), fetal macrosomia (P < 0.01), perinatal mortality (P < 0.01), and primary postpartum hemorrhage (P < 0.05). A significantly higher rate of cesarean deliveries was observed in the multiparous controls (P < 0.01), than the grandmultiparous women.
Conclusion:
Our study shows that there is an increased risk of antenatal anemia, multiple pregnancy, primary postpartum hemorrhage, and adverse perinatal outcomes in grandmultiparous women independent of maternal age.
