Grandmultiparity: experience at Awka, Nigeria

The grandmultiparae have basically been regarded as high risk obstetric patients. This study was undertaken to estimate the prevalence in this area as well as evaluate the problems, associated factors and ways of reducing the burden.

This was a retrospective study of the problems of grandmultiparity (five or more previous viable babies) at Amaku General Hospital, Awka over a three year period, January 2006 to December 2008. One hundred and thirty five (135) grandmultiparous women (study group) were matched with a similar number of women of lower parity (Para 2 and 3), who attended and delivered in the hospital during the same period. The problems seen in both groups during pregnancy and labour, mode of delivery, birth weight, perinatal and maternal mortalities were compared. The soccio-demographic characteristics were also compared.

The incidence of grandmultiparae was 7.53%. Twenty nine (21.5%) of the grandmultiparae were unbooked compared to 6 (4.4%) of the control group. Ninety four (69.7%) of the study group belonged to the low social class IV and V compared to 27 (20%) of the control. Anaemia in pregnancy was commoner in study than in the control group (49 (36.3%) versus 12 (8.9%). There was a high caesarean section rate in the study group compared to the control (31 (23.0%) versus 6 (4.4%). The maternal mortality rate in the study group was 22.2/1000. There was no maternal death in the control.

Improving the socio-economic standard of our women and increased awareness in the importance of family planning will reduce the incidence and complications of grandmultiparity.