Great grand multiparity: is it a risk?

Area of Science:

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

Background:

• High parity, defined as 10 or more deliveries, is associated with unique maternal and fetal risks.
• Previous research has yielded mixed results regarding complications in women with high parity.
• Understanding these risks is crucial for optimizing antenatal and intrapartum care.

Purpose of the Study:

• To compare the incidence of antenatal and intrapartum complications in women with high parity (para ≥ 10) versus low parity (para 2-5).
• To identify specific risks associated with great grand multiparity.

Main Methods:

• Retrospective review of medical records for 154 women with para ≥ 10 (great grand multipara) and 308 women with para 2-5.
• Comparison of antepartum and intrapartum complication rates between the two groups.
• Data collected for deliveries between April 16, 1994, and January 15, 1995.

Main Results:

• Great grand multiparous women were older.
• Incidences of diabetes mellitus, chronic hypertension, and preterm labor were similar between groups.
• Higher incidences of pre-eclampsia (7.1% vs. 2.69%) and intrauterine fetal death (5.2% vs. 1.3%) were observed in great grand multiparous women (P < 0.025).
• Great grand multiparous women also had a higher incidence of macrosomia (12% vs. 12%) (P < 0.0001).
• No significant differences were found in placental abruption, placenta previa, malpresentation, postpartum hemorrhage, or operative delivery rates.

Conclusions:

• Great grand multiparous women are at an increased risk for pre-eclampsia, intrauterine fetal death, and macrosomia.
• These findings underscore the need for vigilant monitoring and tailored management strategies for high-parity pregnancies.