Maternal and Fetal Outcomes of Labor in Grand-Multipara Women

Grand multiparity represented a big challenge facing health institutes and obstetricians especially in developing and poor communities due to accompanying hazards on mothers and fetuses. This study aimed to identify the risk factors and outcomes of grand multiparity among group of Iraqi women. Hence, a prospective clinical study was conducted at labor rooms of Alzahraa Teaching Hospital, Alkut Teaching Hospital and Alshaheed Fairose Hospital) in Al-Kut governorate in Iraq during Jane, 1, 2018 to January, 31, 2019. A total of 1000 pregnant women; 500 pregnant women with grand multiparity (parity ≥ 5) and 500 pregnant women with multiparity history o f (2–4). Data were collected through direct interview and examination of the participated women or from their medical records and then followed for 10 days after labor to assess the maternal and neonatal outcomes. Findings revealed adverse neonatal outcomes in 3.6% of women with grand multiparity which was significantly higher than other ones (p=0.02). The neonatal complications of grand multipara women were intrapartum stillbirth, early neonatal death, birth injury and admission to NICU. A significant association was found between incidence of maternal adverse outcomes and women with grand multiparity (p<0.001). The maternal complications in grand multiparity women were perineal tear, hysterectomy, intrapartum hemorrhage and cord prolapsed. Grand multiparity of pregnant women was significantly related to increased age, unemployment and low educational level. The main obstetrical complications were high rates of cesarean sections and oligohydraminous. In conclusion, grand multiparity was associated with adverse maternal and neonatal outcomes.