Prospective study of maternal and neonatal outcome in great-grand multiparous women (≥10 births) and in aged-matched women with lesser parity.
OBJECTIVE
Evaluation of outcome of labor/delivery in great-grand multiparous (GGMP) women relative to women with lower parity is complicated because of confounding parity with (older) age. Herein, we compare maternal and neonatal outcome in GGMP from a large obstetrics department to that in older women with lesser parity.


METHODS
This was a prospective observational study of older gravid women. All laboring women in a 6-month period were included in this study if they were older than 36 years and had had 2-3 previous births (low parity) or 5-6 previous births (medium parity), and also all women ≥10 births (of any age); all other laboring women were excluded.


RESULTS
GGMP (187 women) relative to low-parity (128 women) and medium-parity (181 women) had higher mean gestational age (39.72 ± 1.8 vs. 39.1 ± 1.8 and 39.15 ± 1.6 weeks; p = 0.0011), mean dilatation at presentation (5.0 ± 2.0 vs. 4.3 ± 2.1 and 4.36 ± 2.0; p = 0.0074), and mean neonatal birth weight (3444.6 ± 540.8 vs. 2376 ± 507.8 and 3272.3 ± 559.5 g; p = 0.0032). GGMP relative to low- and medium-parity women had lower mean gravidity:parity (1.10 vs. 1.3 and 1.19; p < 0.0001); percent missed abortions (8 vs. 28.1 and 43.1%; p = <0.0001); mean second stage (10.4 ± 12.5 vs. 21.2 ± 26.4 and 12.8 ± 17.3 min; p < 0.0001); mean ratio previous cesarean sections: total potential deliveries (0.03 ± 1.07 vs. 0.16 ± 0.25 and 0.09 ± 0.22; p < 0.0001). The low parity group had the least good maternal and neonatal characteristics. There was no maternal or fetal mortality in any group.


CONCLUSIONS
Among older Israeli GGMP women, maternal and neonatal outcome is good and comparable to women of similar age, but lesser parity.
Department of Anesthesiology, Shaare Zedek Medical Center, Jerusalem, Israel.
Angelica
A
Fadeev
Alexander
A
Ioscovitch
Alina
A
Rivlis
Sorina
S
Grisaru-Granovsky
Arnon
A
Samueloff
Michael S
MS
Schimmel
Deborah
D
Elstein
D000328:Adult; D001724:Birth Weight; D036861:Delivery, Obstetric / Q000706:statistics & numerical data*; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007557:Israel / Q000453:epidemiology; D007745:Labor Onset; D007751:Labor, Induced / Q000706:statistics & numerical data; D008297:Male; D008423:Maternal Age; D008875:Middle Aged; D010298:Parity; D011247:Pregnancy; D011256:Pregnancy Outcome; D011446:Prospective Studies