A Dictionary of Nursing. Mutihir J. Obstetric outcomes of the grand multipara in Jos, Nigeria. London W1A 1DP Approximately half (52%) of the grand multiparous subjects had less than 4 antenatal care visits during their pregnancy while 60% delivered at term. Trop J Obstet Gynaecol. What are synonyms for multiparity? This trend may pose substantial risk to the pregnant mother and result in adverse birth outcome. Independent variables included parity status as the main exposure whereby multiparity was defined as a parity of 2 to 4 deliveries while grand multiparity was defined as a parity of 5 or more deliveries. This study found that grand multiparity was associated with maternal and perinatal complications such as prelabour rupture of membranes, stillbirth and preterm birth. This study’s primary aim was to determine the association between GMP and adverse pregnancy outcome. Cite this article. The association of grand multiparity and poor pregnancy outcome has not been consistent for decades. In this test, all pregnancy outcomes assessed in the study were significantly associated with parity status of participants. Data analysis was performed using STATA 12.0 (StataCorp LP, College Station, Texas 77,845 USA). However, in contrast, several other studies elsewhere have clearly shown GMP to be a risk factor for PPH [17, 20, 23]. statement and We also found that GMP was significantly associated with an increased risk of PPH when controlled by maternal age and educational level attainment. Due to increased maternal age and repeated deliveries, the uterine wall becomes weak resulting in inability to adequately contract leading to development of PPH [22]. The main outcome variables include prelabour rupture of membranes (PROM), postpartum hemorrhage (PPH), pre-eclampsia, low birth weight, stillbirth and preterm birth. It was significantly associated with adverse pregnancy outcomes. This could be the case in the present study. Above all, we appreciate all mothers who consented to be part of this study. After data extraction from the main database, data were cleaned, checked for consistency and verification of missing values. This can be explained by the fact that at this particular time, the country had adapted well to the strategic plan developed in 2008 known as One Plan which aimed to provide guidance and improve reproductive, maternal, newborn and child health [16]. It is clinically and … The highest proportion was appreciated in the year 2011 (10.38%) followed by 7.85, 9.43 and 8.49% in the years 2012, 2013 and 2014 respectively (Fig. Open J Obstet Gynecol. Such women are more prone to fetal malpresentations, postpartum haemorrhage, and rupture of the uterus. n, pl -rae (-ˌriː) (Gynaecology & Obstetrics) a woman who has given birth to more than one viable fetus or living child. Adverse pregnancy outcomes associated with grand multiparity were estimated using multivariable logistic regression models. A woman who has given birth one or more times can also be referred to as para 1, para 2, para 3, and so on. Huge disparity in the fertility rate exist between the developed and developing countries. CAS J Med Trop. Hoque M, Hoque E, Kader SB. Toohey JS, Keegan KA, Morgan MA, Francis J, Task S, deVeciana M. The “dangerous multipara”: fact or fiction? Miller-Keane Encyclopedia and Dictionary of Medicine, Nursing, and Allied Health, Seventh Edition. Trop J Obstet Gynaecol. Refer to each style’s convention regarding the best way to format page numbers and retrieval dates. Zainab Muniro. Classifying grand multiparous women as a high-risk group without clear evidence of a consistent association with adverse outcomes can lead to socioeconomic burdens to the mother, family and health systems. Chandra A, Copen CE, Stephen EH. Department of Obstetrics and Gynecology, Kilimanjaro Christian Medical Centre, Box 3010, Moshi, Tanzania, Zainab Muniro, Eusebious Maro & Bariki Mchome, Department of Epidemiology and Biostatistics, Institute of Public Health, Kilimanjaro Christian Medical University College, Box 2240, Moshi, Tanzania, Dar es Salaam Institute of Technology, Department of Science and Laboratory Technology, Box 2958, Dar es Salaam, Tanzania, You can also search for this author in Chi-square test was used to determine the association between a set of maternal pregnancy outcomes and GMP. The code Z64.1 is applicable to female patients only. Since then, medical records for all women who deliver at KCMC and their newborns have been prospectively collected and stored at the medical birth registry. In the present study, we found that the trend of grand multiparity to be decreasing over nine years.. Few data that didn’t demonstrate an increased risk for PPH in grand multiparity could be attributed to a small scale design with inability to capture rare adverse events [13]. An evaluation of the weight of this problem and an understanding of the maternal and fetal outcomes in a rural setting of Cameroon is indispensable as interventions aimed at reducing maternal and neonatal morbi-mortality requires this data. Background: Grand-multiparity has been known to be an obstetric risk because of the documented complications associated with the condition, and it is an indication for booking in a tertiary health institution. The interpretation and clinical application of the word “parity”: a survey. In this study we found a significant increased risk of prelabour rupture of membranes (PROM) in grand multiparous women compared to those with low parity. Trend in grand-multiparity was determined by calculating yearly proportions and displayed using a line graph. Other fetal complications which have been reported in other studies in Tanzania with inadequately controlled intrapartum confounders include meconium stained liquor and low apgar score which were found to be insignificant complications in the present study. A verbal consent to publish individual details (information) were provided by each of the study participants after being explained about the objectives of the medical birth registry and the benefits of the data generated to be shared to the public. This study has demonstrated that GMP women had an increased odds of experiencing stillbirth and preterm births as compared to women with low parity as previously described in published data from Uganda and Nigeria [9, 21, 22]. However, the date of retrieval is often important. The increase use of contraceptives and improved health care delivery is expected to reduce both the prevalence and complications of this condition. 3, JUL – SEP 2014 Data were collected from these women with the help of a pre-designed performa. 1995;172(1):683–6. Lancet. The prevalence of grand multiparity at the institution over nine years found was found to be 9.44%. 2002;109(3):249–53. We are grateful to the collaboration between KCMC and the University of Bergen in Norway for the establishment of the Birth registry that has made this work possible. The condition of being multiparous. Apart from birth registry, each pregnant woman attending this facility has her history documented on patient file with unique file number. What does GM stand for? © 2003 by Saunders, an imprint of Elsevier, Inc. grand multiparity (grand multi-pa-riti) n.the condition of a woman who has had five or more previous pregnancies. Drife J. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. Emechebe C, Njoku C, Eyong E, Maduekwe K, Ukaga J. Ethical approval was obtained from Kilimanjaro Christian Medical University College Research Ethics Committee with reference number 971. Google Scholar. What is the meaning of multiparity? 2010;26(3):181–97 Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4610637/. Trained midwife nurses conduct interviews on daily basis using a standardized questionnaire for all women who deliver at the hospital within 24 h of delivery or immediately after recovery from a complicated delivery. Multiple pregnancies and long periods of breastfeeding may deplete maternal nutritional stores, or perhaps grand multiparas simply prioritize the nutritional needs of their growing families over their own intake. Natl Health Stat Report. Pregnancy complications of grand multiparity at a rural setting of South Africa. The KCMC medical birth registry was established in the year 1999 as pilot and officially started to operate in 2000. Combs CA, Murphy EL, Laros RK. Background: Grand multiparity is a high-risk pregnancy, and it is a common phenomenon in this part of the world, and when added to low socioeconomic status, it significantly increases obstetrics risk to mother and fetus. Article Babinszki A, Kerenyi T, Torok O, Grazi V, Lapinski RH, Berkowitz RL. Correspondence to Grand multipara: The term "multipara" applies to any woman who has given birth 2 or more times. Arch Gynecol Obstet. Moreover, describing a trend of grand multiparity overtime may provide a reflection of effectiveness of contraceptive coverage in this population. Parityis defined as the number of times that she has given birth to a fetus with a gestational age of 24 weeks or more, regardless of whether the child was born alive or was stillborn. The final sample analyzed comprised of 18,441 deliveries (Fig. Antepartum hemorrhage and postpartum hemorrhage (for more information, see our page on maternal bleeding) 2. Precipito… A woman who has given birth 5 or more times is called a grand multipara. Public Company Management of primary postpartum haemorrhage. For practical reasons, the midwives give oral information individually to each mother and then asked her willingness to participate/be enrolled in the study and their data to be used for the public benefits. The dangerous multipara. Grand multiparity may either be a marker for or a cause of poor nutrition. After adjusting for maternal age, maternal education, mothers’ residence, body mass index (BMI), number of antenatal care visits and gestational age, PROM (AOR 1.78; 95% CI: 1.28–2.49) remained significantly associated with grand multiparity. Introduction. 1999;181(3):669–74. Am J Obstet Gynecol. This calls for a need to increase community awareness on its risks, encourage birth control among older women. Since this was a referral hospital-based study, our results may not be generalizable to the general population of Tanzania. A reasonable definition of "grand multiparity" is a woman who has had ≥5 births (live or stillborn) at ≥20 weeks of gestation, with "great grand multiparity" defined as ≥10 births (live or stillborn) ≥20 weeks of gestation . In addition, families with 7 or more children have been associated with low socioeconomic status. BMC Pregnancy Childbirth 19, 222 (2019). Manage cookies/Do not sell my data we use in the preference centre. The ICD-10-CM code Z64.1 might also be used to specify conditions or terms like grand multipara, para 5, para 6, para 7, parity eight, parity nine, etc The code is exempt from present on admission (POA) reporting for inpatient admissions to general acute care hospitals. We excluded multiple pregnancy to avoid overrepresentation of high-risk women which might exaggerate the pregnancy outcomes. A p-value of less than 0.05 (2-tailed) was considered statistically significant. Cite this article. Like gravidity, parity may also be counted. For a pregnancy to count as a "birth", it must go to at least 20 weeks' gestation (the mid-point of a full-term pregnancy) or yield an infant that weighs at least 500 grams, irrespective of whether the infant is liveborn or not. 2013;(67):1–18. Sales: £5.287 billion (US$7.772 billion)…, GRAND PRAIRIE Eze JN, Okaro JM, Okafor MH. Descriptive statistics were summarized using frequency and percentages for categorical variables. Incorporated: 1934 There is some indication that grand multiparity increases the risk of the following obstetrical complications: 1. Look it up now! https://study.com/academy/lesson/multipara-definition-risks.html All authors have read and approved the final manuscript. A total of 18,441 deliveries were analyzed. 1997;104(3):275–7. Great grand multipara have been reported to have an increased incidence in obstetric complications such as fetal malpresentation, placental abruption, … The lower prevalence in developed countries has been attributed to high use of modern family planning and optimal obstetric care while the high prevalence of GMP in low income countries is fueled by gender desirability, low education and desire for more offspring to have large family size [11, 12]. When fetal outcomes were adjusted for the same factors, stillbirth (AOR 1.66; 95% CI: 1.31–2.11) and preterm birth (AOR 1.28; 95% CI: 1.05–1.56) remained statistically significant factors associated with GMP (Table 4). Therefore, be sure to refer to those guidelines when editing your bibliography or works cited list. Infertility and impaired fecundity in the United States, 1982-2010: data from the National Survey of family growth. This study aimed to determine prevalence, trend and associated adverse … © 2003 by Saunders, an imprint of Elsevier, Inc. 2001;18(1):31–3. The overall prevalence of grand multiparity was 9.44% ranging from 9.72% in 2006 to 8.49% in 2014. Viable gestational age varies from region to region. However, addition of other covariates in the model led to non-significant association. lnt J Gynecol Obstet, 1991, 36: 13-16 International Federation of Gynecology and Obstetrics Grand multiparity: a reappraisal of the risks P.A. Studies have examined predictors of intention to use modern contraceptives among women of reproductive age. Demographic and obstetrics characteristics of the study participants are summarized in Table 1. In order to document the consent process, the birth registry has an instruction manual for registration of deliveries in the registry. PIP: Grand multiparity has been considered to be a factor in maternal and neonatal morbidity. Although the GMP proportion has decreased over years, our result reveals a rather gradual decline of GMP overtime. 2016;33(3):327 Available from: http://www.tjogonline.com/text.asp?2016/33/3/327/199808. Grand multiparity is therefore a serious public health issue in Cameroon, particularly in rural zones. Factors associated with postpartum hemorrhage with vaginal birth. A retrospective cross-sectional study was conducted at Kilimanjaro Christian Medical Centre (KCMC) using maternally linked data from medical birth registry. 2007;114(10):1295–7. grand multipara a woman who has had six or more pregnancies that resulted in viable offspring. In the UK: Gravidityis defined as the number of times that a woman has been pregnant. ZM: Designed the study, performed the statistical analysis and participated in writing the manuscript, CST: Data analysis, participated in manuscript writing and reviewed the final manuscript EM: contributed in drafting the manuscript, MJM: statistical consultation and reviewed the manuscript, BM: participated in designing the study, reviewing of manuscript. Grand multiparity as a predictor of adverse pregnancy outcome among women who delivered at a tertiary hospital in Northern Tanzania. Part of The datasets during the current study are not publicly available to protect the participants’ anonymity. The authors declared to have no competing interests. ny • n. Law (in many U.S. states and formerly in Britain) theft of personal property having a value above a legally specified amount. We compared the maternal and perinatal complications among grand … 8, NO. Available from: https://www.globalfinancingfacility.org/sites/gff_new/files/Tanzania_One_Plan_II.pdf. About 64% of grand multiparous women in this study were aged > 35 years and more than half (62.5%) resided in rural area of North-Tanzania. 2). In multivariable regression analyses, our study did not find a significant association between PPH and GMP. Grand multiparity has been associated with increased risks of adverse pregnancy outcomes such as post-partum hemorrhage,gestational hypertension, gestationaldiabetes mellitus and high perinatal mortality.There is limited information about the impact of high parity on pregnancy outcomes in Tanzania. Solomons B. The study also suggests a need for establishment of a referral system unit at this institution that will be specifically managing deliveries occurring in women with high parity as well as advanced age.