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Grandmultiparity. Is it a perinatal risk?
A Samueloff1, M S Schimmel, A I Eidelman
1Department of Obstetrics and Gynecology, Shaare Zedek Medical Center, Jerusalem, Israel.
Clinics in Perinatology
|October 21, 1998
Summary
High parity, or giving birth multiple times, is not always a risk for perinatal outcomes in healthy, economically stable populations with good medical care. Focus should be on healthcare quality, not parity alone.
Area of Science:
- Obstetrics and Gynecology
- Maternal Health
- Public Health
Background:
- Increased parity is often associated with lower socioeconomic status and older maternal age.
- This demographic profile can lead to a higher incidence of antenatal complications like hypertension and diabetes.
Purpose of the Study:
- To re-evaluate the impact of high parity on perinatal outcomes.
- To investigate the role of socioeconomic factors and healthcare access in this relationship.
- To challenge the traditional concept of the 'dangerous multipara'.
Main Methods:
- Analysis of recent studies on the Israeli maternal population.
- Inclusion of comparable international reports.
- Examination of socioeconomic conditions and healthcare access in relation to parity and perinatal outcomes.
Main Results:
- Conflicting previous reports on high parity's effect on perinatal outcomes may stem from socioeconomic differences in study populations.
- In economically stable populations with access to quality medical care, high parity is not consistently linked to adverse perinatal outcomes.
- Socioeconomic status and healthcare quality appear to be significant confounding factors.
Conclusions:
- The term 'dangerous multipara' is outdated and potentially misleading.
- The focus should shift from parity itself to the quality and accessibility of medical services provided to pregnant individuals.
- Optimizing healthcare delivery is crucial for improving perinatal outcomes, irrespective of parity.