Trends in the occurrence of antenatal and perinatal complications with increasing parity

In modern days, grand multiparity is confined to communities where contraception is not practiced because of social and religious beliefs. For this reason, it is quite prevalent in all GCC countries. Few studies have compared the outcomes between the three groups: low parity (2-4), grand multiparity (5-9), and great grand multiparity (10 and more) . This study intended to analyze the trends in the occurrence of various perinatal complications across these three groups.

This historical cohort study was conducted in Mafraq Hospital, Abu Dhabi between January 1, 2009 and December 31, 2011. There were 1,658 multipara, 1,198 grand multipara, and 160 great grand multipara.

Different complications revealed different trends with increasing parity. Many antenatal and intrapartum complications like diabetes (overt and gestational), anemia, preterm delivery, malpresentation at term, postpartum hemorrhage, and macrosomia showed a linear increase with increasing parity, while some, like the need for labor augmentation and soft tissue injuries showed a declining trend with increasing parity. Interestingly, some complications like placenta praevia, need for induction of labor, cesarean delivery, and post-term delivery followed an inverted V curve, showing an increase in their occurrence up to parity nine but a decline thereafter with further increasing parity of ten or beyond.

Women in different parity groups were at risk of different complications. There are some complications which decrease with increasing parity, and perinatal mortality remains very low suggesting that in modern settings, with favorable socioeconomic conditions and access to high-quality healthcare, a satisfactory perinatal outcome can be expected with low morbidity and mortality.