Grand multiparity–an obstetric problem in Great Britain in the 90s?

Summary

To assess the obstetric risk of grand multiparity we conducted a retrospective case control study over a two-year period. Defining grand multiparity as parity >5 we identified 229 cases; matched controls were within 5 years of age and parity 1. We found significantly more Jewish and Muslim patients, a discrepancy of greater than 2 weeks between menstrual date and dating ultrasound scan at 16 weeks, and significantly higher anaemia rates in the grand multi-parae (P<0–01). Antenatal admission rates including antepartum haemorrhage were similar, but the grand multiparous group had significantly less analgesic use in labour, a shorter second stage and a higher intact perineum rate. Mode of delivery, gestation, age, birth weight, Apgar scores and postpartum haemorrhage rates did not differ. There were three stillbirths in the 229 grand multiparous group, with none in the control group, with no neonatal deaths in either group. With modern obstetric management protocols, grand multi-parity does not appear to be an obstetric risk factor.