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The problem of grandmultiparity in current obstetric practice
F T Mwambingu1, A A Al Meshari, A Akiel
1Department of Obstetrics and Gynaecology, King Abdul Aziz University Hospital, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
Summary
Grandmultipara mothers experienced increased risks of gestational diabetes and hemorrhage but decreased rates of anemia and perinatal death. Modern perinatal care likely contributed to these improved outcomes.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
- Public Health
Background:
- Grandmultiparity, defined as five or more previous deliveries, has been associated with increased pregnancy risks in some studies.
- Previous research indicated higher rates of complications in grandmultiparas compared to women with fewer pregnancies.
- Understanding contemporary outcomes in grandmultiparas is crucial for optimizing perinatal care.
Purpose of the Study:
- To compare pregnancy outcomes between Arab grandmultiparas and non-grandmultiparas.
- To identify specific complications with altered incidences in grandmultiparas.
- To evaluate the impact of modern perinatal care on grandmultipara outcomes.
Main Methods:
- Retrospective analysis of 646 Arab women undergoing hospital confinement between 1983 and 1985.
- Comparison of complication rates between grandmultiparas and non-grandmultiparas.
- Statistical analysis to determine significant differences in incidences.
Main Results:
- Grandmultiparas showed increased incidences of gestational diabetes, hypertension, rheumatic heart disease, antepartum/postpartum hemorrhage, and macrosomic infants.
- Conversely, grandmultiparas exhibited decreased incidences of anemia, cesarean sections, induced labor, dysmaturity, and perinatal deaths.
- These findings contrast with some earlier reports on grandmultiparity outcomes.
Conclusions:
- Modern specialist perinatal care and improved socioeconomic standards may mitigate risks associated with grandmultiparity.
- Grandmultiparity in this cohort did not correlate with universally worse outcomes, suggesting the influence of advanced medical care.
- Further research is warranted to confirm these findings and explore contributing factors.
Keywords:
Acceptor CharacteristicsAcceptorsArab CountriesAsiaData AnalysisDemographic FactorsDeveloping CountriesDiseasesEconomic FactorsEpidemiologic MethodsFamily PlanningFamily Planning ProgramsFertilityFertility MeasurementsIncidenceMeasurementMultiparityParityPopulationPopulation CharacteristicsPopulation DynamicsPregnancyPregnancy ComplicationsPregnancy OutcomesPrevalenceReproductionResearch MethodologyResearch ReportRetrospective StudiesSaudi ArabiaSocioeconomic FactorsSocioeconomic StatusStudiesUrban PopulationWestern Asia