Grand Multiparity: Risk Factors and Outcome in a Tertiary Hospital: a Comparative Study

Alsammani, Mohamed Alkhatim; Ahmed, Salah Roshdy

doi:10.5455/msm.2015.27.244-247

Cited by 46 publications

(60 citation statements)

References 10 publications

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“…In this study, multiparity was associated with poor-SRH at the time of the interview, a finding consistent with other studies that report multiparity to be associated with postpartum poor health status [15, 17]. Multiparity constitutes the potential risks of pregnancy and postpartum adverse outcomes [15].…”

Section: Discussionsupporting

confidence: 90%

Self-reported pregnancy-related health problems and self-rated health status in Rwandan women postpartum: a population-based cross-sectional study

Semasaka

Krantz

Nzayirambaho

et al. 2016

BMC Pregnancy Childbirth

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BackgroundSelf-rated health status (SRH) can be used as a predictor of morbidity and mortality. Postpartum self-rated health has been used to estimate maternal morbidity and postpartum problems. Reproductive history factors are associated with poor self-rated health postpartum. This study investigated prevalence of self-reported health problems during first, second, and third trimesters of pregnancy, delivery, and postpartum. In addition, this study investigated SRH in Rwandan women up to 13 months from partus.MethodsThis population-based, cross-sectional study collected data in 2014 using structured interviews (N = 921). Univariable analysis was used to identify variables that were associated with poor self-rated health status (poor-SRH). Logistic regression analyses were performed to identify factors associated with poor-SRH at one day, one week, and one month postpartum and at the time of the interview.ResultsMean time between latest delivery and the time of interview was 7.1 months. Prevalence of anaemia, hypertension, diabetes mellitus during pregnancy, and severe bleeding during pregnancy and labour were 15.0, 4.9, 2.4, and 3.7 %, respectively. The prevalence of poor-SRH was 32.2 % at one day postpartum, 7.8 % at one month, and 11.7 % at time of the interview. Hypertension during pregnancy and significant postpartum haemorrhage were associated with poor-SRH at one day and one week postpartum. Severe bleeding during pregnancy and labour were associated with poor-SRH at one week and one month postpartum. Infection and anaemia during pregnancy were associated with poor-SRH at one month postpartum and at the time of interview. The Kaplan-Meier curves illustrate restitution of health for most women during the study period.ConclusionsThis population-based study reports a high prevalence of poor SRH status among Rwandan women in the early postpartum period. Identified factors associated with poor-SRH were severe bleeding, hypertension, infection, and anaemia during pregnancy and postpartum haemorrhage. These factors may be prevented or reduced by providing more frequent and specific attention during pregnancy and by providing timely measures that address complications during delivery, including adequate postpartum care.

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Section: Discussionsupporting

confidence: 90%

Self-reported pregnancy-related health problems and self-rated health status in Rwandan women postpartum: a population-based cross-sectional study

Semasaka

Krantz

Nzayirambaho

et al. 2016

BMC Pregnancy Childbirth

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“…The majority of the studies argued that grand multiparas are more likely to be of old age which might be the reason for increased morbidity and mortality (14). Conversely, it has been defined that nulliparous mothers had an increased risk of preterm birth and preeclampsia compared to multiparous women (15).…”

Section: Discussionmentioning

confidence: 99%

Four or More Cesarean Sections, is it Still Safe?

Yücel

Kadiroğullari²,

Karahasan³

et al. 2017

Gynecol Obstet Reprod Med

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OBJECTIVE:We aimed to compare the maternal and neonatal complications in women who had undergone fourth or more cesarean section with to women who had undergone second or third cesarean section.STUDY DESIGN: 162 women who had four or more cesarean section (study group) and 228 women who had undergone second or third cesarean section (control group) were reviewed retrospectively. Demographic features, obstetric, intraoperative, postpartum and neonatal complications were determined in both groups. RESULTS:The preoperative hematocrit values were lower in study group (35.6±3.6) than the control group (36.6±4.3), (p<0.001). Patients with four or more cesarean sections had an increased rate (24.7%) of intra-abdominal dense adhesions compared with the controls (14.9%), (p<0.001). Blood transfusion rate was higher in the study group (8.6% to 3.5%, p=0.043). Except these; frequencies of obstetric, intraoperative, postpartum and neonatal complications were similar between groups. CONCLUSION:We found that multiple CSs (four or more) do not increase the risk of maternal or neonatal complications except the rate of maternal anemia, dense adhesions and need for blood transfusion according to the results of our study. Fourth or more cesarean section appears to be still a safe procedure.

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“…Thirty-four cohort studies (42.0%) were identified as a prospective design (19 in [81], and three in the UAE). Fiftytwo (64.2%) cohort studies enrolled pregnant mothers at varying stages of their pregnancy with different characteristics such as diabetic and non-diabetic mothers [26,67], obesity [42,47,54], singleton [41,48,99] or triplet pregnancies [91], teenage women [112], multipara women [82,86,98], and women with systemic lupus erythematosus (SLE) [27]. Eight studies (9.9%) enrolled pregnant mothers at varying stages after delivery [24,49,58,59,81,84,88,99].…”

Section: Study Characteristicsmentioning

confidence: 99%

Maternal and birth cohort studies in the Gulf Cooperation Council countries: a systematic review and meta-analysis

et al. 2020

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Background: We systematically reviewed and chronicled exposures and outcomes measured in the maternal and birth cohort studies in the Gulf Cooperation Council (GCC) countries and quantitatively summarized the weighted effect estimates between maternal obesity and (1) cesarean section (CS) and (2) fetal macrosomia. Methods: We searched MEDLINE-PubMed, Embase, Cochrane Library, Scopus, and Web of Science electronic databases up to 30 June 2019. We considered all maternal and birth cohort studies conducted in the six GCC countries (Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and United Arab Emirates (UAE)). We categorized cohort studies on the basis of the exposure(s) (anthropometric, environmental, medical, maternal/reproductive, perinatal, or socioeconomic) and outcome(s) (maternal or birth) being measured. Adjusted weighted effect estimates, in the form of relative risks, between maternal obesity and CS and fetal macrosomia were generated using a randomeffects model. Results: Of 3502 citations, 81 published cohort studies were included. One cohort study was in Bahrain, eight in Kuwait, seven in Qatar, six in Oman, 52 in Saudi Arabia, and seven in the UAE. Majority of the exposures studied were maternal/reproductive (65.2%) or medical (39.5%). Birth and maternal outcomes were reported in 82.7% and in 74.1% of the cohort studies, respectively. In Saudi Arabia, babies born to obese women were at a higher risk of macrosomia (adjusted relative risk (aRR), 1.15; 95% confidence interval (CI), 1.10-1.20; I 2 = 50%) or cesarean section (aRR, 1.21; 95% CI, 1.15-1.26; I 2 = 62.0%). Several cohort studies were only descriptive without reporting the magnitude of the effect estimate between the assessed exposures and outcomes. Conclusions: Cohort studies in the GCC have predominantly focused on reproductive and medical exposures. Obese pregnant women are at an increased risk of undergoing CS delivery or macrosomic births. Longer-term studies that explore a wider range of environmental and biological exposures and outcomes relevant to the GCC region are needed. Systematic review registration: PROSPERO CRD42017068910

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Grand Multiparity: Risk Factors and Outcome in a Tertiary Hospital: a Comparative Study

Cited by 46 publications

References 10 publications

Self-reported pregnancy-related health problems and self-rated health status in Rwandan women postpartum: a population-based cross-sectional study

Self-reported pregnancy-related health problems and self-rated health status in Rwandan women postpartum: a population-based cross-sectional study

Four or More Cesarean Sections, is it Still Safe?

Maternal and birth cohort studies in the Gulf Cooperation Council countries: a systematic review and meta-analysis

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