Grandmultiparity: Evaluating obstetric and neonatal outcomes after eliminating confounders
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Date
2014-03
Journal Title
Journal ISSN
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Publisher
National Postgraduate Medical College of Nigeria
Abstract
Aims and Objectives: The objective was to evaluate obstetric and neonatal
outcomes in booked grandmultiparas (para e”5) and compare with outcome
in age and social status matched booked multiparas (para 2-4) after
eliminating confounders.
Patients and Methods: A cohort study with grandmultiparas (subjects) and age
and social status matched multiparas as controls. All participants were counseled
and an informed consent obtained at the antenatal clinic. Maternal demography
and history were taken; they were subsequently monitored during pregnancy,
labour and immediate puerperium. The main outcome measures were obstetric
and neonatal outcomes among subjects and controls.
Results: The incidence of grandmultiparity was 4.1%. During antenatal period,
grandmultiparas had statistically significantly higher occurrence of late
antenatal booking (P=0.0202), anaemia (P=0.0024) and past history of poor
perinatal outcome (P=0.0124).
Grandmultiparas had statistically significant occurrence of preterm delivery
(P=0.0389) and higher but not statistically significant mean duration of labour
(P=0.3532), intrapartum complications (P=0.2014) and postpartum
haemorrhage (P=0.2126). Neonates of grandmultiparas had statistically
significant low first minute Apgar scores (P=0.0011) with higher but not
statistically significant occurrence of low birth weight (P=0.1613) and neonatal
intensive care admission (P=0.7202). The perinatal mortality rates were 136
and 75 per 1 000 deliveries for grandmultiparas and multiparas. There were no
maternal deaths during the study period.
Conclusion: After controlling for age and social class, booked grandmultiparas
had poorer obstetric and neonatal outcome compared to booked multiparas but
these were majorly statistically insignificant due to effect of modern antenatal
care.
Description
Keywords
Grandmultipatiry, Obstetrics, Neonatal, Outcome, Confounders