Abstract
Purpose of investigation: The impact of grand multiparity on perinatal outcomes remains unknown. The authors aimed to assess perinatal outcomes in grand multiparous women in Jordan. Materials and Methods: In this retrospective case-control study of 161 grand multiparous and 163 multiparous women, maternal and neonatal outcomes were assessed. Statistical analysis included logistic regression with adjustment for age and booking status. Results: The prevalence of grand multiparity was 1.8%. Grand multiparous women had a significantly higher risk of gestational hypertension, diabetes, preterm delivery, and cesarian section, but significantly lower risk of requiring labor augmentation and perineal tears. Neonates of grand multiparous had a significantly higher risk of low birth-weight (LBW) and requiring NICU admission. However, after adjustment, none of these retained statistical significance. Conclusion: Risk of gestational diabetes, hypertension, preterm labor, cesarean section, LBW, and NICU admission were primarily related to advanced maternal age rather than grand multiparity in Jordanian women.
Highlights
Grand multiparity is considered an obstetric hazard for both a pregnant mother and her newborn [1]
The study conforms to the provisions of the Declaration of Helsinki, and ethical approval was obtained from the Institutional Review Board at Jordan University Hospital (JUH) and the Deanship of Scientific Research at The University of Jordan
This was a retrospective case-control study covering a 24month period between January 1st, 2011 and December 31st, 2012 that recruited women managed at JUH (Amman, Jordan)
Summary
Grand multiparity is considered an obstetric hazard for both a pregnant mother and her newborn [1]. Neonates of grand multiparous women have been reported to have lower Apgar scores [1], a higher risk for low-birth-weight (LBW) status, neonatal intensive care unit (NICU) admission [7], and fetal macrosomia [4, 10]. Developed countries report a decline in the incidence and severity of adverse outcomes in grand multiparity, reflecting the improvement in standard obstetric and perinatal care; such complications are primarily and independently associated with increased maternal age alone [11]. Grand multiparity remains prevalent in many developing countries [12] and is considered a major burden in obstetric care provision. While the prevalence of grand multiparity is usually lower in developed countries, the number of children in the family is not always related to the country’s income or economy. The high rate of grand multiparity could reflect a lower education level, reduced access to modern contraceptive methods, and the lack of legislation permitting the artificial interruption of pregnancy [16]
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