This could be explained by the fact that since AMA is a major risk for various maternal complications, thus fetus and neonates may always be susceptible to mortality and morbidity. Hence, it may suffice to say that, in this population, PPH is well explained by GMP condition, maternal age and education level. 2016;16(1):1–6.  Those that have given birth twice may also be described as "secondiparous", in which case "pluriparous" is applied to those that have given birth three times or more. The mean age of women in the study group was 30.4 (SD = 5.6) years. Jos J Med. [ mul″tĭ-par´ĭ-te] the condition of being a multipara; called also pluriparity. This page was last edited on 27 November 2020, at 18:09. Alsammani M, Ahmed S. Grand multiparity: risk factors and outcome in a tertiary hospital: a comparative study. The grand multiparous women had increased odds of prelabour rupture of membranes (Adjusted odds ratio [AOR] 1.78: 95% CI:1.28–2.49), stillbirth (AOR 1.66: 95% CI:1.31–2.11) and preterm birth delivery (AOR 1.28; 95% CI: 1.05–1.56) as compared to women in the lower parity group. Few data that didn’t demonstrate an increased risk for PPH in grand multiparity could be attributed to a small scale design with inability to capture rare adverse events . Among other factors, grand multiparity is hypothesized to play a significant role in adverse maternal outcomes especially in low-and-middle income countries like Tanzania. BJOG An Int J Obstet Gynaecol. Asian Pacific J Reprod 2016;5(3):214–220. The objective was to compare the obstetric outcome of grand-multiparous women with that of low parity in our center. Grand multiparity as a predictor of adverse pregnancy outcome among women who delivered at a tertiary hospital in Northern Tanzania. volume 19, Article number: 222 (2019) It is different from PARITY, which is the number of offspring borne. In multivariable regression analyses, our study did not find a significant association between PPH and GMP. Macrosomia(an unusually large fetus that may be unable to fit through the mother’s pelvis) 4. Ministry of Health Community Development Gender Elderly and Children. According to the Tanzania National Census of 2012, the population of Kilimanjaro region is estimated to be 1.6 million people. We therefore recommend future prospective study to explore the association of GMP with maternal mortality. BJOG An Int J Obstet Gynaecol. multiparity. 2002;109(3):249–53. F. Gary Cunningham, 2005. However, this is slightly lower compared to other studies which reported the high prevalence of 10.2 and 26.5% respectively [9, 13]. For a pregnancy to count as a "birth", it must go to at least 20 weeks' gestation (the mid-point of a full-term pregnancy) or yield an infant that weighs at least 500 grams, irrespective of whether the infant is liveborn or not. The prevalence of grand multiparity among women in North-Tanzania was 9.44%. , Number of times a woman has given birth to a baby, "Gravida" redirects here. Arch Gynecol Obstet. Look it up now! Manage cookies/Do not sell my data we use in the preference centre. These include: Though similar, GPA should not be confused with the TPAL system, the latter of which may be used to provide information about the number of miscarriages, preterm births, and live births by dropping the "A" from "GPA" and including four separate numbers after the "P", as in G5P3114. However, addition of other covariates in the model led to non-significant association. Open J Obstet Gynecol. Moreover, describing a trend of grand multiparity overtime may provide a reflection of effectiveness of contraceptive coverage in this population. Zainab Muniro. 2005;7(1):14–20. Grand Multiparity : obstetric outcome in comparison with multiparous women in a developing country. Grand-multiparity (GMP) condition has been defined differently in several literature [1,2,3]. 1997;104(3):275–7. In biology and human medicine, gravidity and parity are the number of times a woman is or has been pregnant (gravidity) and carried the pregnancies to a viable gestational age (parity). The study warrants more emphasis to be directed towards community sensitization on the adverse maternal and fetal outcomes that might be attributable to GMP. This study aimed to determine prevalence, trend and associated adverse pregnancy outcomes of grand multiparity in a tertiary hospital in Northern Tanzania. Great grand multipara have been reported to have an increased incidence in obstetric complications such as fetal malpresentation, placental abruption, … Google Scholar. The KCMC medical birth registry was established in the year 1999 as pilot and officially started to operate in 2000. BMC Pregnancy Childbirth 19, 222 (2019). Opara EI, Zaidi J. The study site has better schools and universities that provides with an opportunity to learn and become aware of reproductive health status. According to the CDC report of 2004, the prevalence of grand multiparity was reported as low as 3–4% in developed countries as compared to 19.3% in developing countries, [9, 10]. Chandra A, Copen CE, Stephen EH.  A woman who has given birth once is primiparous and is referred to as a primipara or primip. Huge disparity in the fertility rate exist between the developed and developing countries. Mater Sociomed. See also: Birth. The authors declared to have no competing interests. Part of 2001;18(1):31–3. A reasonable definition of "grand multiparity" is a woman who has had ≥5 births (live or stillborn) at ≥20 weeks of gestation, with "great grand multiparity" defined as ≥10 births (live or stillborn) ≥20 weeks of gestation . Mehrzad J, Duchateau L, Pyörälä S, Burvenich C. (2002). Since then, medical records for all women who deliver at KCMC and their newborns have been prospectively collected and stored at the medical birth registry. Like gravidity, parity may also be counted. 2). Classifying grand multiparous women as a high-risk group without clear evidence of a consistent association with adverse outcomes can lead to socioeconomic burdens to the mother, family and health systems. Ogbe AE, Ogbe BP, Ekwempu C. Obstetric outcome in grand multiparous women in Jos teaching hospital. For practical reasons, the midwives give oral information individually to each mother and then asked her willingness to participate/be enrolled in the study and their data to be used for the public benefits. Grand-multiparity (GMP) condition has been defined differently in several literature [ 1, 2, 3 ]. A retrospective cross-sectional study was conducted at Kilimanjaro Christian Medical Centre (KCMC) using maternally linked data from medical birth registry. Our result is consistent with previous studies done in Nigeria that describe a 3.6–4.2% increase in PROM in grand multiparas as compared to multiparas [16, 17]. The crude and adjusted analysis for the association between grand multiparity and adverse pregnancy outcomes are displayed in Table 3 and Table 4 respectively. Despite the strengths, there were some limitations that should be considered while interpreting findings from this study. Afolabi AF, Adeyemi AS. Information on the neonates who are admitted in the neonatal care unit were recorded in neonatal registry forms. This study found that grand multiparity was associated with maternal and perinatal complications such as prelabour rupture of membranes, stillbirth and preterm birth. This study’s primary aim was to determine the association between GMP and adverse pregnancy outcome. This was a cross-sectional study using maternally linked data from Kilimanjaro Christian Medical Centre (KCMC) medical birth registry. The final sample analyzed comprised of 18,441 deliveries (Fig.  When using these terms: In human medicine, "gravidity" refers to the number of times a woman has been pregnant, regardless of whether the pregnancies were interrupted or resulted in a live birth. Trop J Obstet Gynaecol. 1999;181(3):669–74. Available from: https://doi.org/10.1016/j.apjr.2016.04.012. 1991;77(1):69–76. Parity, or "para", indicates the number of pregnancies reaching. Descriptive statistics were summarized using frequency and percentages for categorical variables. 2002;101(1):22–5. Terms and Conditions, Due to increased maternal age and repeated deliveries, the uterine wall becomes weak resulting in inability to adequately contract leading to development of PPH . We excluded multiple pregnancy to avoid overrepresentation of high-risk women which might exaggerate the pregnancy outcomes. In attempt to minimize overrepresentation of high–risk women, we excluded women with multiple pregnancy. These files are confidential and contain all patients’ medical records stored at the hospital medical record department. By using this website, you agree to our Low-and-middle income countries including Tanzania’s fertility rate have still relatively high annual fertility rate as compared to high income countries . statement and A woman who has given birth 5 or more times is called a grand multipara. 2017;7(7):707–18. © 2003 by Saunders, an imprint of Elsevier, Inc. All rights reserved. The increase use of contraceptives and improved health care delivery is expected to reduce both the prevalence and complications of this condition. ICD-10-CM Code for Supervision of pregnancy with grand multiparity, third trimester O09.43 ICD-10 code O09.43 for Supervision of pregnancy with grand multiparity, third trimester is a medical classification as listed by WHO under the range - Pregnancy, childbirth and the puerperium . Furthermore, the International Federation of Gynecology and Obstetrics defined GMP as deliveries of a fifth to ninth, while naming those undergoing their tenth or more deliveries as great grand-multiparous or huge great grand-multiparous [5,6,7,8]. 2) Related to a multipara. grand multiparity (grand multi-pa-riti) n. the condition of a woman who has had five or more previous pregnancies. BJOG An Int J Obstet Gynaecol. When using these terms: Permission to use medical birth registry was obtained from KCMC administrative authority. Gynecology and obstetrics risk factors for primary postpartum haemorrhage. The Chi-square test for pregnancy outcomes and parity is shown in Table 2. Although the GMP proportion has decreased over years, our result reveals a rather gradual decline of GMP overtime. 1997;259:179–87. Women having their first birth after the age of 35 years had a 40% increased risk compared to those with a first birth before the age of 20 years.. Drife J. The highest proportion was appreciated in the year 2011 (10.38%) followed by 7.85, 9.43 and 8.49% in the years 2012, 2013 and 2014 respectively (Fig. The social class and reasons for grand multiparity in Calabar, Nigeria. Eze JN, Okaro JM, Okafor MH. However, the first five (5) years in the trend show no bigger differences while in the year 2011 the rise is seen and then followed by the decline. D. Vecchio, G. Neglia, M. Rendina, M. Marchiello, A. Balestrieri, R. Di Palo (2007). Correspondence to Study of factors affecting breast-feeding initiation in the golden hour in a tertiary care centre Accessed 15 Dec 2018. CAS Combs CA, Murphy EL, Laros RK. Maternal socio-demographic characteristics included maternal age, residence, level of education, religion, number of antenatal care ANC-visits, gestational age, body mass index (BMI) and marital status. Stillbirth or neonatal death. Adverse pregnancy outcomes associated with grand multiparity were estimated using multivariable logistic regression models. The average deliveries per year is around 4000. Pregnancy complications of grand multiparity at a rural setting of South Africa. For example, a woman who is described as 'gravida 2, para 2 (sometimes abbreviated to G2 P2) has had two pregnancies and two deliveries after 24 weeks, and a woman who is described as 'gravida 2, para 0' (G2 P0) has had two pregnancies, neithe… Its establishment was a result of a collaborative project between KCMC and the medical birth registry of Norway through University of Bergen. Cookies policy. For other uses, see. In addition, maternal mortality, as one of the important outcomes was not investigated in this study due to insufficient information regarding maternal deaths in the dataset. Muniro, Z., Tarimo, C.S., Mahande, M.J. et al. Njoku CO, Abeshi SE, Emechebe CI. Multiparous: 1) Having multiple births. As Sustainable Development Goal’s (SDG) efforts to address promotion of maternal health and reduction of child mortality becomes intensified, regional specific investigation to inform the public health on potential effect of factors that presents a significant risk to the pregnant mother and the birth outcome are imperative. Gravida indicates the number of times a woman is or has been pregnant, regardless of the pregnancy outcome. Am J Obstet Gynecol. Schematic Diagram of the selected study participants. However, other definitions are … After data extraction from the main database, data were cleaned, checked for consistency and verification of missing values. Still birth was defined as fetal death of ≥28 weeks of gestation age while preterm birth was defined as babies born alivebefore 37 weeks of pregnancy are completed. Such women are more prone to fetal malpresentations, postpartum haemorrhage, and rupture of the uterus. The main outcome variables include prelabour rupture of membranes (PROM), postpartum hemorrhage (PPH), pre-eclampsia, low birth weight, stillbirth and preterm birth. 2016. It is the number of times a female has: Gravidity means having been pregnant, regardless of whether it has been brought to viability (yet alone term), including the current pregnancy: . multiparity. This manual contains the standard operating procedures on how to conduct the interview and also has a description of the basic rules including ethical guidelines such as consent process. Perinatal outcome in grand and great-grand multiparity: effects of parity on obstetric risk factors. Adverse outcomes associated with GMP include diabetes, premature labor, maternal and perinatal mortality, placenta previa, genital sepsis, postpartum hemorrhage (PPH), utero-vaginal prolapse, hypertension and Intrauterine fetal death (IUFD) [6, 7, 10, 13]. Precipito… Since this was a referral hospital-based study, our results may not be generalizable to the general population of Tanzania. Williams Obstetrics, 22nd Edition, McGraw-Hill Companies. A "multigravida" or "secundigravida" is a woman who has been pregnant more than one time. In a NHANES study from 19992006, risk factors for iron deficiency included multiparity, current pregnancy, and regular menstrual cycles. Department of Obstetrics and Gynecology, Kilimanjaro Christian Medical Centre, Box 3010, Moshi, Tanzania, Zainab Muniro, Eusebious Maro & Bariki Mchome, Department of Epidemiology and Biostatistics, Institute of Public Health, Kilimanjaro Christian Medical University College, Box 2240, Moshi, Tanzania, Dar es Salaam Institute of Technology, Department of Science and Laboratory Technology, Box 2958, Dar es Salaam, Tanzania, You can also search for this author in Delivery-care facilities should prepare for emergency situation when attending deliveries of high parity group. 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