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Published on: June 18, 2013
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.
Objective:
Our purpose was to compare the intrapartum complication incidence among grand multiparous women with that of age-matched control multiparous women.
Study Design:
A total of 382 grand multiparous women (para > or = 5) were compared with 382 age-matched control subjects (para 2 to 4), all delivering between July 1989 and September 1991. Intrapartum complications classically associated with grand multiparity (abruptio placentae, dysfunctional labor, fetal malpresentation, postpartum hemorrhage, and shoulder dystocia) were compared.
Result:
Both groups had comparable antepartum complications and gestational ages at delivery. The overall intrapartum complication incidence for grand multiparous women was 33% (127/382 patients), not significantly different from that of the control multiparous women, 27% (103/382). Grand multiparity was associated with an increased incidence of macrosomia (16% vs 11%) and a decreased incidence of operative delivery (14% vs 21%). Macrosomia increased the incidence of intrapartum complications from 31% to 46% (p < 0.03) in the grand multiparous patients, and a trend was observed in the multiparous patients, from 26% to 37%. However, when properly controlled, this was noted to be a confounding variable and was not related to parity.
Conclusions:
In a largely Hispanic population grand multiparous patients do not have an increased incidence of intrapartum complications.
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