Grand-multiparity has been known to be an obstetric risk because of the
documented complications associated with the condition, and it is an
indication for booking in a tertiary health institution. The increase use of
contraceptives and improved health care delivery is expected to reduce both the
prevalence and complications of this condition. Aims and Objectives: To determine the prevalence of grandmultiparity, and if it is still associated with the previously documented
complications in the obstetric population presenting at Ladoke Akintola University
of Technology (LAUTECH) Teaching Hospital, Osogbo. Materials and Methods: A
case controlled retrospective study of grand-multiparous women presenting in
our institution over a period of ten years. All grandmultiparous women within
the study period were identified from the labour ward register, and women with
parity 2 - 4 served as control. Statistical analysis was done using SPSS 14.
Statistical significance was set at p < 0.05. Logistic regression was done
to adjust for confounding variables. Result: There were 5126 deliveries during
the study period, and grand-multiparous constituted 128 (2.49%) of these
deliveries. Grand-multiparity was found to be associated with pre-labour rupture of membranes, 16.2% versus 4.0% (p = 0.004), hypertensive diseases in pregnancy, 27.1% versus 8.1% (p =
0.001), placenta praevia, 15.3% versus 4.0% (p = 0.007) and other medical illnesses,
23.2% versus 6.1% (p = 0.001). Post-partum haemorrhage, anaemia, puerperal
sepsis and urinary tract infections were found to be significantly commoner
in the grand-multiparous than in the lower parity group (p < 0.05). After
adjusting for confounding variables grand-multiparity was still found to be
significantly associated with complications at delivery (OR = 2.70; 95% CI 1.13
- 6.48) and poor fetal outcome (OR = 2.28; 95% CI
1.11 - 4.65). Conclusion: Although the prevalence of grand-multiparity is
on the downward trend, it still remained an obstetric risk, therefore, the
importance of booking and delivery in a well-equipped facility should be emphasized among the obstetric population so as to reduce the complications that
were found to be associated with the condition.
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