title: Impact of grandmultiparity on obstetric outcome in low resource setting.
abstract: OBJECTIVE
  This study was undertaken to evaluate the impact of grandmultiparity on obstetric outcome in a low resource setting.
  
  
  METHODS
  Two hundred and eighty-two antenatal grandmultiparous women (parity ≥ 4) were compared with consecutive 564 antenatal women with parity 1-3.
  
  
  RESULTS
  There were 13 403 deliveries over the study period from Jan 2006-December 2008 at CSMMU, Lucknow. The prevalence of grandmultipara was 2.3%. Grandmultipara were older (P < 0.001) and more commonly from rural areas (P < 0.001) as compared to the control group. The percentage of Muslims among grandmultipara (23.8%) was higher than among controls (16.5%), P < 0.01. Grandmultipara had significantly higher prevalence of anemia (P < 0.001), malpresentation (P = 0.01) and rupture uterus (P < 0.001). Abruptio placenta, placenta previa and obstructed labor were seen more often in grandmultipara, and the difference was statistically significant (P < 0.01 in each group). There was no difference in terms of mode of delivery, sex of newborn or the prevalence of low birthweight (<2.5 kg) babies. Stillbirths were more common in grandmultiparas (P < 0.001). There was one maternal death in the study group.
  
  
  CONCLUSIONS
  Grandmultiparity continues to be of grave concern with an adverse impact on obstetric and perinatal outcome.
authors.affiliation: Department of Obstetrics and Gynecology, Chhatrapati Shahuji Maharaj Medical University, Lucknow, India. smritijainagrawal@rediffmail.com
authors.forename: Smriti
authors.initials: S
authors.lastname: Agrawal
authors.forename: Anjoo
authors.initials: A
authors.lastname: Agarwal
authors.forename: Vinita
authors.initials: V
authors.lastname: Das
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D003906:Developing Countries; D005260:Female; D006295:Health Resources / Q000191:economics; D006801:Humans; D007194:India / Q000453:epidemiology; D008428:Maternal Mortality; D007744:Obstetric Labor Complications / Q000453:epidemiology; D010298:Parity; D011204:Poverty Areas; D011247:Pregnancy; D011256:Pregnancy Outcome; D015995:Prevalence; D012189:Retrospective Studies; D055815:Young Adult