Grandmultiparity: a potential risk factor for adverse pregnancy outcomes

To assess the incidence of antenatal and intrapartum and perinatal outcomes in grandmultiparae in an affluent society with available modern perinatal care.

A case-control study in a tertiary referral hospital in Eastern Saudi Arabia of 2,122 grandmultiparae was undertaken. Each patient was compared with an age-matched multipara who delivered during the 10-year study period. Data was obtained from the computerized hospital information systems and their statistical analysis performed to determine the significant categorical variables.

Grandmultiparity was associated with a significantly higher risk of iron deficiency anemia, diabetes mellitus, antepartum hemorrhage, malpresentation, cesarean section rate, postpartum hemorrhage and a high perinatal mortality rate. There was no significant difference in chronic hypertension in pregnancy, preterm labor, congenital fetal malformations, obstructed labor and cord prolapse between the two groups of patients.

Grandmultiparae are a high-risk obstetric group of patients liable to develop a number of antepartum and intrapartum complications with adverse neonatal outcome. The best prophylaxis of these high risks in pregnancy would be the prevention of grand multiparity. Women need to be informed of the dangers of high-order births and advised to practice effective family planning methods to prevent pregnancy.