Grandmultiparity. Is it a perinatal risk?
Increased parity is more common in lower-socioeconomic groups. Additionally, GMPs tend to be older. It is for these reasons that there is a tendency for an increased incidence of antenatal complications, such as hypertension and diabetes, among GMP mothers. It appears that the previous conflicting reports on the effect of high parity on perinatal outcome can be related to differences in the socioeconomic conditions of the parturient population under examination. Previous evidence of the unfavorable influence on perinatal outcome of high parity might have been biased by patient selection, because high parity is often inversely linked to social class. Our recent studies of the Israeli maternal population plus comparable reports from other countries allow us to conclude that GMP is not always a great cause for concern in an economically stable and healthy population that has access to high-quality medical care. As such, the term dangerous multipara should be removed from the medical literature and the focus of concern should shift to the organization and the delivery of quality medical services.
Department of Obstetrics and Gynecology, Shaare Zedek Medical Center, Jerusalem, Israel.
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A
Samueloff
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MS
Schimmel
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Eidelman
D000328:Adult; D036861:Delivery, Obstetric / Q000379:methods; D005260:Female; D006801:Humans; D007557:Israel; D008423:Maternal Age; D010298:Parity; D011247:Pregnancy; D011248:Pregnancy Complications / Q000209:etiology*; D011256:Pregnancy Outcome; D018566:Pregnancy, High-Risk; D012307:Risk Factors; D012959:Socioeconomic Factors