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The grandmultipara: is she still a risk?
A I Eidelman1, R Kamar, M S Schimmel
1Department of Pediatrics, Albert Einstein College of Medicine, Yeshiva University, Bronx, New York.
American Journal of Obstetrics and Gynecology
|February 1, 1988
Summary
Grandmultiparity, or having many previous births, does not increase maternal or perinatal risks in a well-supported population. This study found no increased risks for mothers with high parity, suggesting socioeconomic factors were key in prior research.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
- Public Health
Background:
- Grandmultiparity has been historically associated with increased maternal and perinatal mortality and morbidity.
- Previous studies often confounded parity with socioeconomic status, limiting understanding of grandmultiparity's independent risks.
Purpose of the Study:
- To investigate the independent effect of grandmultiparity on maternal and perinatal outcomes.
- To dissociate the impact of high parity from socioeconomic factors in a unique population.
Main Methods:
- A retrospective study of 7785 mothers in Jerusalem, with 889 identified as grandmultiparas.
- Comparison of outcomes between grandmultiparous mothers and all other mothers.
Main Results:
- No significant increase in hypertension, diabetes, uterine atonia, hemorrhage, cesarean sections, stillbirths, or congenital malformations was observed in grandmultiparas.
- Grandmultiparas showed significantly lower neonatal mortality and low birth weight rates.
- A higher incidence of multiple births and trisomy 21 was noted in the grandmultipara group (p < 0.01).
Conclusions:
- Grandmultiparity itself does not appear to be a significant risk factor for adverse maternal or perinatal outcomes in a healthy, economically stable population with modern medical care.
- Previous associations of increased risk with grandmultiparity may be attributable to confounding socioeconomic factors rather than parity per se.