The grand multipara--maternal and neonatal complications

Area of Science:

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

Background:

• Grand multiparity, defined as five or more previous births, is associated with potential pregnancy risks.
• Previous research indicates varied outcomes for high-parity pregnancies, necessitating further investigation.

Purpose of the Study:

• To compare antenatal and delivery complications, perinatal mortality, and neonatal morbidity in grand multiparous women versus a control group.
• To identify specific risks associated with grand multiparity.

Main Methods:

• Retrospective analysis of records from 1974-1983.
• Comparison of grand multiparous women with a control group of second and third parae.
• Data collection included antenatal complications, labor management and complications, puerperium complications, perinatal mortality, and neonatal morbidity.

Main Results:

• Grand multiparous women showed an increased tendency for abruptio placentae and placenta praevia, leading to higher rates of induced preterm delivery.
• Abnormal presentations and positions were more frequent in the grand multipara group.
• Perinatal mortality was significantly higher (23.5%) in grand multiparous women compared to the control group (0%).
• Increased incidence of neonatal morbidity and one maternal death from dissecting aortic aneurysm were observed in the grand multipara group.

Conclusions:

• Grand multiparity is associated with increased risks of placental complications, preterm birth, abnormal presentations, and higher perinatal mortality.
• These findings underscore the need for careful monitoring and management of high-parity pregnancies.