title: The clinical outcome in pregnancies of grand grand multiparous women.
abstract: OBJECTIVE
  To longitudinally evaluate maternal and neonatal complications with relation to birth order, with specific emphasis on grand grand multiparity (at least 10th para).
  
  
  METHODS
  The maternal and neonatal outcome of 1200 pregnancies/deliveries in 96 grand grand multiparas was longitudinally investigated in 4 stages of the mothers' life: the primiparas, the multiparas (2nd-5th paras), the grand multiparas (6th-9th paras) and the grand grand multiparas stage.
  
  
  RESULTS
  The frequency of hypertension, diabetes, placental complications, operative interventions at delivery, macrosomic infants, chromosomal abbreviations and fetal/neonatal anomalies increased with increasing birth order, being at a maximum in grand grand multiparas. The preterm delivery and perinatal mortality rate did not differ between the 3 groups of multiparas. Perinatal outcome was good in each group.
  
  
  CONCLUSIONS
  Grand grand multiparity carries the risk of hypertensive and diabetic complications, which, in turn, often lead to induced or operative deliveries and placental complications. However, grand grand multiparity is not a major problem in societies with a good maternal health care system.
authors.affiliation: The Family Federation, Infertility Clinic of Oulu, Finland.
authors.forename: K
authors.initials: K
authors.lastname: Juntunen
authors.forename: P
authors.initials: P
authors.lastname: Kirkinen
authors.forename: A
authors.initials: A
authors.lastname: Kauppila
mesh_terms: D001034:Apgar Score; D001722:Birth Order; D005260:Female; D005387:Finland; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D008137:Longitudinal Studies; D010298:Parity; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D011256:Pregnancy Outcome