Grand Multiparity: Obstetric Outcome in Comparison with Multiparous Women in a Developing Country

Grand-multiparity is a serious risk factor in pregnancy and common in developing countries. The objective was to compare the obstetric outcome of grand-multiparous women with that of low parity in our center. The study comprised of 150 grand-multiparous women (cases) and 150 multiparous women (para 2 - 4) in this index pregnancy as controls matched for age and admitted for delivery. The mean age of the grand-multiparous women at delivery was 37.0 ± 2.8 years. Grand-multiparity was significantly higher among women with only primary education (48.0% versus 44.7%), polygamous marriages (9.3% versus 3.3%) and Muslims (17.3% versus 6.7%). Pregnancy induced hypertension and primary postpartum hemorrhage were significantly more often seen among grand-multiparous women than among the controls. The mean packed cell volume before delivery in the grand-multiparous women was significantly lower (33.6% ± 2.7%) than in the multiparous group (35.2% ± 2.7%) (P-value = 0.000). Grand-multiparity with its associated complications still occurs frequently in our environment. However, with adequate antenatal surveillance, optimal care during labour and contraceptive use, these problems will be reduced.