Grandmultiparity: Reasonfor index pregnancy, contraception and relationship to the Millenium Development Goals
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Date
2014
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Publisher
School of Medicine, Kenyatta University, Kenya
Abstract
Objective: To evaluate the reasons for index pregnancy and contraceptive use among grandmultiparas and relate these to the Millennium Development Goals (MDG).Design: A matched case control study. Setting: The antenatal clinic of the Department of Obstetrics andGynaecology of the University of IlorinTeaching Hospital, Ilorin, Nigeria.
Subjects/ participants: Subjects weregrandmultiparas (para ≥5) who presented
for antenatal care at the antenatal clinicof the hospital while controls were equal number of age, educational level and social status matched multipara (para 2-4)
at the antenatal clinic from 1st January to 31st June, 2010 selected by purposive
sampling. Main outcome measures: Level of education, social status, awareness
and use of contraceptives, reasons forindex pregnancy and the relationship of
these characteristics to the Millennium Development Goals. The data was analyzed
using EPI-INFO 6 statistical package with p-value, odds ratio and confidence interval.
Results: There were 66 grandmultiparas during the study period; 30% had no formal
education while 66.7% were of low social status with 30.3% in social class IV and
36.4% in class V. Contraceptive awareness and use were similar in grandmultiparas
and controls; awareness was [90.9% vs. 93.9%, OR=0.65, CI= 0.17-2.4, P 0.7422]
while use was 6.4% vs. 40.9%, OR= 0.83, CI= 0.41-1.66, P=0.7207. In both groups,
the commonest contraceptive method was Depo-provera [16.7% vs. 15.1%,
OR=1.12, CI=0.44-2.85, P 0.8120] while barrier method was the least used
[3.0% vs. 6.1%, OR=0.48, CI=0.09-2.74, P=0.6761]. The mother’s reasons for
index pregnancy were desire for more children in 33.3%, previous perinatal death in 28.8% and desire for a specific gender in 19.7% of grandmultiparas. Conclusions: Majority of grandmultiparas were poor, uneducated with desire for large families, poor contraceptive users and suffered previous poor perinatal outcome. This is an indicator of a huge gap to fill in attaining the Millennium Development Goal-5 to improve maternal health by reducing maternal mortality by three quarters by 2015.
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Keywords
Grandmultipatiry, Grandmultipara