title: Grandmultiparity and pregnancy outcome in Aba, Nigeria: a case-control study.
abstract: OBJECTIVE
  To compare the incidence of antenatal and intrapartum complications and perinatal outcomes among women who had delivered five or more times (grandmultiparous) with those of age-matched controls who had delivered two to four times (multiparous).
  
  
  METHODS
  A case-control study.
  
  
  METHODS
  A tertiary referral hospital in Aba, Nigeria.
  
  
  METHODS
  Seven hundred and thirty-four grandmultiparous women were compared with 734 age-matched multiparous controls.
  
  
  METHODS
  Maternal case records were retrieved from medical records department and analyzed with additional information obtained from the labor ward records. Statistical analysis was done using EPI info version 6; χ² test was used to analyze categorical variables.
  
  
  RESULTS
  Grandmultiparity was associated with a significantly higher risk of antenatal anemia (P < 0.05), multiple pregnancy (P < 0.01), fetal macrosomia (P < 0.01), perinatal mortality (P < 0.01), and primary postpartum hemorrhage (P < 0.05). A significantly higher rate of cesarean deliveries was observed in the multiparous controls (P < 0.01), than the grandmultiparous women.
  
  
  CONCLUSIONS
  Our study shows that there is an increased risk of antenatal anemia, multiple pregnancy, primary postpartum hemorrhage, and adverse perinatal outcomes in grandmultiparous women independent of maternal age.
authors.affiliation: Abia State University Teaching Hospital, Aba, Nigeria.
authors.forename: E
authors.initials: E
authors.lastname: Akwuruoha
authors.forename: C
authors.initials: C
authors.lastname: Kamanu
authors.forename: Stephen
authors.initials: S
authors.lastname: Onwere
authors.forename: B
authors.initials: B
authors.lastname: Chigbu
authors.forename: C
authors.initials: C
authors.lastname: Aluka
authors.forename: C
authors.initials: C
authors.lastname: Umezuruike
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D036861:Delivery, Obstetric; D004522:Educational Status; D005260:Female; D006801:Humans; D008875:Middle Aged; D009549:Nigeria / Q000453:epidemiology; D010298:Parity; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology* / Q000209:etiology; D011256:Pregnancy Outcome