title: The effect of grandmultiparity on pregnancy related complications: the Aga Khan University experience.
abstract: BACKGROUND
  Grandmultiparity has been associated with complications for both mother and the fetus.
  
  
  OBJECTIVE
  To evaluate if grandmultiparity is a risk factor in the presence of adequate antenatal care.
  
  
  METHODS
  A tertiary care teaching hospital.
  
  
  METHODS
  It was a retrospective study conducted in the department of Obstetrics & Gynecology at The Aga Khan University Hospital in Karachi. During this period 9253 women were delivered, out of these 143 booked grandmultiparas (GMP) served as cases. The outcome of these women was compared with 430 non-grandmultiparas (NGMP). Logistic regression model was used to adjust for potential confounders.
  
  
  RESULTS
  Grandmultiparas had almost three times increased risk of having postpartum hemorrhage compared to NGMP group. Similarly, there were significantly low five-minute apgars in the GMPs compared to the NGMP group. Although the neonatal intensive care admissions were three times more in the GMPs but this did not reach statistical significance due to small number of cases in both groups.
  
  
  CONCLUSIONS
  Our study indicates that grandmultiparity is a risk factor for pregnancy in this part of the world, even in the presence of reasonable antenatal care. This may be explained on the basis of the increased age of these women. Finally, we also recommend that an age-matched study needs to be undertaken in order to determine if age is an important determinant for risk factors in grandmultiparas.
authors.affiliation: Department of Obstetrics, Aga Khan University Medical Centre/College, Karachi.
authors.forename: S
authors.initials: S
authors.lastname: Munim
authors.forename: M H
authors.initials: MH
authors.lastname: Rahbar
authors.forename: M
authors.initials: M
authors.lastname: Rizvi
authors.forename: N
authors.initials: N
authors.lastname: Mushtaq
mesh_terms: D000328:Adult; D001724:Birth Weight; D005260:Female; D006801:Humans; D016015:Logistic Models; D008423:Maternal Age; D010298:Parity; D006473:Postpartum Hemorrhage / Q000209:etiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000209:etiology*; D011256:Pregnancy Outcome; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors