Grand multiparity: an obstetric or neonatal risk factor?

Area of Science:

• Obstetrics and Gynecology
• Perinatal Medicine
• Maternal-Fetal Medicine

Background:

• Grand multiparity (seven or more births) is often linked to increased maternal and neonatal morbidity.
• Socioeconomic status can confound outcomes associated with grand multiparity.
• Previous research has not fully isolated the effects of grand multiparity from socioeconomic factors.

Purpose of the Study:

• To investigate the perinatal outcomes of grand multiparity.
• To minimize confounding socioeconomic status effects by studying a homogeneous population.
• To determine if grand multiparity is independently associated with adverse maternal or neonatal outcomes.

Main Methods:

• Retrospective cohort study of 5916 deliveries at Bikur Cholim hospital in Jerusalem.
• Comparison of outcomes between grand multiparous women (n=893) and a control group.
• Analysis adjusted for potential confounders, including maternal age and socioeconomic status.

Main Results:

• Grand multiparous women had a significantly lower incidence of small-for-gestational-age infants (3.6% vs. 5.8%).
• Grand multiparous women had a significantly higher incidence of large-for-gestational-age infants.
• No significant increase in obstetric complications, neonatal morbidity, or mortality was observed in the grand multiparity group.

Conclusions:

• Grand multiparity is not associated with increased perinatal morbidity or mortality when socioeconomic status is controlled.
• The study suggests grand multiparity may be associated with larger fetal size.
• Findings challenge the traditional view of grand multiparity as an inherently high-risk condition.