Grandmultiparity in Malaysian Women

Abstract

Grandmultiparity is an ill defined term, but it is generally believed that increasing parity after the fifth delivery increases the risks of child bearing for both the mother and fetus. Four hundred seventy-seven women aged less than 35 years of parity 5 and above who delivered during one year period at the University Hospital, Kuala Lumpur were studied. There were 4-06 women of parity 5 and 6 and 71 women of parity 7 and above. The 2 groups as a whole comprised 7.5% of the obstetric population for that year. Obstetric performance in the 2 groups of grandmultipara was compared with 1,135 women, aged 25 to 34 years, having their second baby during the same period. Women of parity 7 and above were significantly more likely to be from lower socioeconomic groups, and suffer from anaemia, hypertension and preeclampsia. They were also significantly at risk of preterm delivery and delivering infants weighing less than 2.5 kg. In addition, the perinatal mortality rate was significantly greater in the highly parous group (Para >7) than in women of parity 5 and 6 or the control group. Apart from a significant increase in the incidence of anaemia, women of parity 5 and 6 had a similar obstetric performance and perinatal outcome to that of the control group. We conclude that grandmultiparity per se is not an obstetric risk factor until after the seventh delivery. These findings have implications for those who plan the provision of obstetric services for the community.

Grand multiparity: is it still a risk in pregnancy?

“…However, a significantly higher prevalence of a history of preterm delivery and neonatal loss was evident in grand multiparas, a finding that was similar to a study conducted in Malaysia [23]. The reason for such findings could be related to a recurrence of pregnancy risk of fetal and neonatal death.…”

“…The age disparity between the two groups was managed by comparing the prevalence of important variables using age-adjusted ORs. A similar comparison methods has been used in other studies [23] whereas other authors have conducted age matching from the time of sampling [26]. …”

“…MNH is a National referral hospital which also serves as a teaching hospital for the Muhimbili University of Health and Allied Sciences (MUHAS). Dar es Salaam has, according to the 2002 census, a population of ≈2.5 million and an annual growth in population of 4.3% [23]. Referrals that are served at MNH come from municipal hospitals and health centers in Dar es Salaam as well as Bagamoyo and Kisarawe district hospitals in the neighboring coastal region for antenatal care, delivery or intensive care.…”

“…These factors together or independently may predispose the mother to anemia, diabetes mellitus (DM), hypertension, malpresentation, abruptio placentae, placenta previa, post-partum hemorrhage due the uterine atony, and uterine rupture [17-19]. Poor perinatal outcomes include low birth weight, prematurity and perinatal mortality [20-23]. GM has also been associated with previous loss of pregnancy such as intrauterine fetal death and perinatal death [24].…”

A Comparative Study to Asses the Outcome of Grand Multipara With That of Great Grand Multipara

“…(21) The study done budey states that frequency of PIH was double in grand multipara when compared with nongrand multipara. The incidence was 9% in grand multipara.…”