Grand multiparity - a continuing threat: a 6-year review

Area of Science:

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

Background:

• Grand multiparity, defined as five or more previous deliveries, is associated with potential obstetric risks.
• Previous studies have indicated a possible link between high parity and adverse pregnancy outcomes.
• Understanding the specific risks in grand multiparous women is crucial for modern obstetric care.

Purpose of the Study:

• To evaluate the frequency of pregnancy and labor complications in grand multiparous women.
• To assess the impact of antenatal care on maternal and fetal outcomes in this population.
• To compare the risks in grand multiparas with the general obstetric population.

Main Methods:

• Retrospective review of 1005 grand multiparas delivering between 1968 and 1973.
• Analysis of pregnancy complications, including antepartum hemorrhage, hypertensive disorders, and malpresentations.
• Assessment of antenatal care utilization and its correlation with infant birth weight and stillbirth rates.
• Comparison of perinatal and maternal mortality rates with the total hospital population.

Main Results:

• An increased incidence of antepartum hemorrhage, hypertensive disorders, and malpresentations was observed in grand multiparas.
• Nearly a quarter of patients received inadequate or no antenatal care.
• Infants of mothers with no antenatal care had significantly higher rates of low birth weight and stillbirth.
• Perinatal mortality was nearly doubled, and maternal mortality was 10-fold higher in grand multiparas compared to the general obstetric population.

Conclusions:

• Grand multipara remains a high-risk obstetric patient, posing significant risks to both maternal and fetal well-being.
• The findings underscore the critical importance of adequate antenatal care for grand multiparous women.
• These results have significant clinical implications for managing high-parity pregnancies in contemporary obstetric practice.