title: Grand Multiparity: Risk Factors and Outcome in a Tertiary Hospital: a Comparative Study.
abstract: OBJECTIVE
  The aim of the current study was to determine the prevalence of grand multiparity and the associated risks factors.
  
  
  METHODS
  Four hundred thirty grandmutliparas (parity 5 or more) were compared with multiparous population (parity 2-4) with regard to maternal age, gestational age, mode of delivery, fetal and maternal outcomes and inter-current medical and obstetrical problems.
  
  
  RESULTS
  There were significant association between grand multiparity and adverse pregnancy outcomes such as cesarean delivery (OR=2.699, CI=2.072-3.515, p<0.001), fetal macrosomia (OR=1.675; 95% CI=1.004- 2.796, p=.048), Diabetes mellitus (OR=1.634, 95%CI=1.076-2.481, p=0 .021), and pregnancy induced hypertension (OR=1.838, 95% CI=1.054-3.204, p= .032). No significant associations were seen in placenta abruption, placenta previa, preterm labor, postpartum hemorrhage and the frequency of admission to neonatal intensive care unit. No prenatal or maternal mortality was reported in this study.
  
  
  CONCLUSIONS
  Grand multiparty remains a major obstetrics problem. It is associated with many medical and obstetrical complications. In communities where large family is desirable it is important to address the value of family planning and conduction of meticulous antenatal care.
authors.affiliation: Department of Obstetrics & Gynecology, College of medicine, Qassim University, Saudi Arabia. Department of Obstetrics & Gynecology, College of medicine, BahriUniversity, Sudan.
authors.forename: Mohamed Akhatim
authors.initials: MA
authors.lastname: Alsammani
authors.affiliation: Department of Obstetrics & Gynecology, College of medicine, Qassim University, Saudi Arabia. Department of Obstetrics & Gynecology, College of medicine, BahriUniversity, Sudan.
authors.forename: Salah Roshdy
authors.initials: SR
authors.lastname: Ahmed
keywords: Grand multiparity; Neonatal morbidity; Obstetric complications; Pregnancy outcome