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Related Experiment Videos

The "dangerous multipara": fact or fiction?

J S Toohey1, K A Keegan, M A Morgan

  • 1Department of Obstetrics and Gynecology, University of California, Irvine, Orange 92668.

American Journal of Obstetrics and Gynecology
|February 1, 1995
PubMed
Summary

Grand multiparous women (five or more births) did not experience more intrapartum complications than multiparous women with fewer births. Macrosomia was a factor in complications but not directly linked to grand multiparity.

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Area of Science:

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

Background:

  • Grand multiparity, defined as five or more births, has historically been associated with increased obstetric risks.
  • However, contemporary evidence on intrapartum complication incidence in grand multiparous women compared to age-matched controls is limited.

Purpose of the Study:

  • To compare the incidence of intrapartum complications between grand multiparous women (para ≥ 5) and age-matched multiparous women (para 2-4).

Main Methods:

  • A retrospective comparison of 382 grand multiparous women and 382 age-matched control multiparous women delivering between July 1989 and September 1991.
  • Key intrapartum complications, including abruptio placentae, dysfunctional labor, fetal malpresentation, postpartum hemorrhage, and shoulder dystocia, were analyzed.

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Main Results:

  • Overall intrapartum complication rates were similar: 33% in grand multiparous women versus 27% in controls.
  • Grand multiparity showed a higher incidence of macrosomia (16% vs. 11%) and lower operative delivery rates (14% vs. 21%).
  • Macrosomia significantly increased intrapartum complication risk, but was identified as a confounding variable unrelated to parity.

Conclusions:

  • Grand multiparous women in this cohort did not exhibit an increased incidence of intrapartum complications compared to controls.
  • The findings suggest that parity alone may not be an independent risk factor for intrapartum complications when other variables are controlled.