Grand multiparity—its obstetric implications

Abstract

3105 cases of infants of at least 20 weeks gestation delivered at Hazard and Whitesburg Memorial Hospitals during the period April 1956-March 1961 were reviewed and grand multiparas (6 or more pregnancies terminated after at least 20 weeks gestation) were compared to women of parity 1-5 to determine the relationship between average birth weight maternal weight gain during pregnancy incidence of stillborn infants number of prenatal visits and number of neonatal deaths. Also comparisons were made relating age and parity of the mother to a variety of obstetrical factors and complications of pregnancy. There were 725 grand multipara deliveries by 516 women. Average birthweight was greater among multiparas. Occurrance of infants of 2500 gm or less was unrelated to parity while incidence of infants 10 pounds or more was greater among multiparas. The incidence of stillborns increased in the grand multipara 2.86% as compared to 1.31% para 1-5 and increased with age. Maternal factors were responsible for the majority of stillbirths regardless of parity. Increasing parity was unrelated to neonatal deaths or length of gestation. Transverse lie face and brow presentations increased among grand multiparas. Several maternal complications were also more frequent including heart disease and diabetis mellitus. Hypertension as a complication of pregnancy and preeclampsia both increased with grand multiparity and with age of patient. Grand multiparas also showed increases in incidence of primary uterine inertia prenatal anemia and postpartum hemorrhage.