Obstetric Outcome in Grandmultiparous Women in Jos University Teaching Hospital

Abstract

Background: The grandmultipara is traditionally regarded in Obstetrics as a high risk in pregnancy. However, some authors believe that if matched for age and socioeconomic status in a setting of satisfactory health care conditions, grandmultiparity should not be considered dangerous. This study determined the maternal morbidity and mortality and perinatal outcomes associated with grandmultiparity among women who came to deliver in Jos University Teaching Hospital.
Method: This hospital based prospective case control study was carried out between June 2008 and January 2009 in the labour ward of the maternity unit of Jos University Teaching Hospital among 250 consecutive grandmultiparous women and another 250 consecutive women of parity 2 to 4 who were matched for age and socioeconomic status.
Result: The 250 grandmultiparous women and their matched multiparous group had an average age of 32.9 ± 4.6 years. Grandmultiparous women were significantly more likely to develop hypertensive disease in pregnancy, have malpresentaion and develop postpartum haemorrhage. Their fetuses were significantly more likely to have fetal distress in labour, to be low birth weight babies and be admitted to the special care baby unit (SCBU).
Conclusion: In the developing countries where the health care delivery system is still facing a lot of challenges, the grandmultipara should still be considered a high risk in pregnancy.