Grandmultiparity: Is it really an independent predictor of adverse pregnancy outcomes?

Abstract

Context: Grandmultiparity has been associated with increased adverse maternal and perinatal outcomes mostly in poor-resource settings. The question remains to what extent parity on itself contributes to unfavorable obstetric outcomes. There are limited studies that control for other predictor variables of maternal and perinatal outcomes in high parity pregnancies. Aim: This compared the adverse maternal and perinatal outcomes among grand multiparas with age-matched low parous counterparts to generate data for focused obstetric care. Subjects and Methods: An age-matched case–control study was performed on 2009–2014 data of all the high parity births in a second-tier mission hospital in a state capital city, Nigeria. Selected maternal and fetal outcome variables were compared between the women of high parity (para ≥5) and low parity (para 1–4). The primary outcomes were adverse maternal and perinatal variables. The statistical tests were done with statistical significance at 0.05) with stillbirths, low birth weight, macrosomia, preterm birth, chronic hypertension, gestational hypertension anemia, induction of labor, cephalopelvic disproportion/obstructed labor, and cesarean section. Conclusions: The prevalence of grandmultiparity was low at 2.52%. With the exception of abnormal lie, high parity was not associated with increased adverse fetal and maternal outcomes in this study.