During the follow up four women refused to participate in the study due to certain reasons after being involved in the study cohort leaving 816 study subjects giving a response rate of 97.5%. More specifically, multipara means to describe a woman who has experienced two or more viable pregnancies which result in potentially viable offspring. Mansfield. Hoque M, Hoque E, Kader SB. Disclaimer. Woday A, Muluneh MD, Sherif S. Determinants of preterm birth among mothers who gave birth at public hospitals in the Amhara region, Ethiopia: a case-control study. Women who had multiparity (Para 2 to 4) were enrolled as a non-exposed group. J Adv Med Medl Res. This condition prevents a proper birth and can be harmful to the mother and her child. The SlideShare family just got bigger. After adjusted for confounders, women with grand multiparity gave birth to babies with a higher risk of stillbirth (ARR = 1.6; 95% CI: 1.01 2.51), macrosomia (ARR = 1.6; 95% CI: 1.23 2.07), and preterm birth (ARR = 1.3; 95% CI: 1.1 1.66) compared to their counterparts.Conclusion: High incidences of adverse perinatal outcomes occurred among women with grand multiparity. Placenta previa is one risk associated with advanced maternal age multipara. 2017;11(2):172174. Maternal and fetal outcomes of labor in grand-multipara women. A.) Grand multiparty remains a major obstetrics problem. Our doctors define difficult medical language in easy-to-understand explanations of over 19,000 medical terms. We recommend that the region and districts health bureau should give close monitoring for pregnant women with high parity throughout their prenatal, intrapartum, and postpartum periods.Keywords: birth complication, parity, fetal abnormality, cohort, Sidama, Ethiopia, Grand multiparity is a condition when a woman has at least five deliveries at gestational age greater than or equal to 20 weeks.13 In many developed countries, grand multiparity is becoming less of a concern with a low prevalence of 24% whereas it is still a public health issue of great concern in developing countries and is a high prevalence of 19%.46, Low-and-middle-income countries including Ethiopias grand multiparity have still relatively high perinatal outcomes complications compared to high-income countries.79 Evidence has shown that grand multiparity increases the incidence of medical and obstetric complications such as anemia, birth asphyxia, preterm birth, low birth weight, macrosomia, low APGAR scores, stillbirth, and a high perinatal mortality rate.1013 With this connection, grand multipara is associated with higher risks factors of medical and obstetric complications for mothers and fetuses.4,7,1416. WebManagement In antennal care good nutrition, prophylactic and therapeutic iron and folic therapy to prevent and treat iron and folic acid deficiency anemia is must. Recommend this site Int J Gynecol Obstet. Reprod Health. doi:10.9734/JAMMR/2018/42931. 3095 Kingswood Blvd. Grand multiparity (GMP) was defined in the older literature as giving birth seven times or higher [].More recent reports describe it as parity of five or more [].With the widespread application of family planning in developed countries, GMP has decreased in Western society and its prevalence became very low (~4% of all births) [].In many parts of The region is divided into 36 districts (6 urban districts and 30 rural districts) with one Hawassa city administration. Grand multiparity: obstetric performance in Aminu Kano teaching hospital, Kano, Nigeria. Devon has tutored for almost two years. The Sidama people number 8.8 million (4.01% of the national population). Adeniran A, Fawole A, Fakeye O, et al. BMC Pediatr. I feel like its a lifeline. By study design, the mean age of each group was 34.8 4.8 years (range 2147; less than 25 years, n = 19; 2529 years, n = 75; 3034 years, n = 172; 3540 years, n = 241; more than 40 years, n = 114). The term multipara is used to describe the number of pregnancies and child births that a woman has experienced. Permission was obtained from the Sidama Regional Health Bureau. Kassa GM, Arowojolu AO, Odukogbe AA, Yalew AW. Webantenatal care grand multiparity is no longer been considered a risk factor for poor maternal outcome. BMC Pregnancy Childbirth. It is important to recognize the risks of multigravida and multipara so that the health of both mother and child can be more definitely ensured. Ethical principles for medical research involving human subjects. Accessibility - Size & Definition, What Is the Uterus? Nevertheless, grand multiparty might not be discouraged as long as women are provided with good perinatal care. 17. In addition, social, cultural, economic, and religious factors affect the prevalence of grand multiparity. This finding was comparable to the studies conducted in Ethiopia (19%), Nigeria (25%), and Bangladesh (23%).22,25,50 Also, the finding showed that the risk of preterm birth was higher with grand multiparity. Yet, limitations observed in this study include the follow-up periods were not included after perinatal periods, and for some cases, gestational age was reported subjectively rather than objectively. 2012;4:289. doi:10.2147/IJWH.S32190. While 5-digit GTPAL system provides more comprehensive data on obstetric history at a glance. In some previous studies [2,3], one of main perinatal complications associated with precipitous labor has been reported to be placental abruption, because placental abruption can cause tachysystole, and thus shorter deliveries. Which of the following outcomes indicates that the medication is effective? Out of the 17 hospitals, 5 (30%) hospitals were selected purposively which provided full packages of maternal and newborn services in the region. Grand multiparas tend to be older than patients of lower parity. Khatun J. Obstetrical outcome of grand multipara. [2],[3]Despite the government's population policies which favor the small family size,[7]high parity still remains a common feature of our obstetric practice in developing countries,[1],[2],[3],[4],[5],[6]with an overall incidence of 10-30%, with higher rates in the Muslim countries, where there is a large-family norm and poor acceptance of family planning methods. Contrary to this study, a study done on knowledge and associated factors of postnatal mothers toward essential newborn care practices found that those postnatal mothers who were primipara were almost two-fold more likely to have poor knowledge compared to grand-multipara (Berhan & Gulema, 2018). This is an increasingly rare occurrence in modern society, especially in comparison to child birth rates following World War II. Double data was entered using EpiData version 3.02 software. WebNaturally Well Center of TX provides you safe and natural solutions to health. Grand multiparity remains a risk in pregnancy and is associated with an increased prevalence of maternal and neonatal complications (malpresentation, meconium-stained liquor, placenta previa and a low Apgar score) compared with other multiparous women who delivered at Muhimbili National Hospital. Open J Obstet Gynecol. Qamar A, Asif U, Qamar S. Maternal and fetal outcome in grand multipara. Al-Shaikh GK, Ibrahim GH, Fayed AA, Al-Mandeel H. Grand multiparity and the possible risk of adverse maternal and neonatal outcomes: a dilemma to be deciphered. World Health Organization. It appears that you have an ad-blocker running. Although the multipara definition may suggest that all multipara births are healthy and alive, the term is used to describe deliveries regardless of the outcome (both living and deceased). 2017;17(1):310. doi:10.1186/s12884-017-1508-0, 15. Moazzem Hossain S, El NS, Ibrahim S, et al. Mater Sociomed. Postnatal assessment and management. In different studies conducted in developing countries, adverse perinatal outcomes are significantly associated with grand multiparity compared with multiparity.1,4,7,10,15,1726 The majority of the studies carried out in developing countries, including Ethiopia, implemented incomplete registration of perinatal data with limited variables. 2022 Jul 4:1-9. doi: 10.1007/s11845-022-03076-w. Online ahead of print. 2017;6(2):77. doi:10.4103/sjhs.sjhs_98_16. MATERIAL AND METHODS Some of the included potential confounding variables were socio-demographic characteristics: maternal age, religion, ethnicity, household wealth status, education of respondents, education of husband and occupation; obstetrics and some medical factors: history of preterm birth, history of stillbirth, and unplanned pregnancy. Gebremeskel F, Gultie T, Kejela G, Hailu D, Workneh Y. Determinants of adverse birth outcome among mothers who gave birth at hospitals in Gamo Gofa Zone, Southern Ethiopia: a facility based case control study. - Symptoms, Causes & Treatment, What Is Gynecomastia? They also are AT-CTI certified. International Statistical Classification of Diseases and Related Health Problems, Tenth Revision. The inclusion criteria for the study were: 1. Our objectives were to evaluate the management of GMP in contemporary obstetrics and to assess whether grand multiparas are still high-risk patients. In order to provide our website visitors and registered users with a service tailored to their individual preferences we use cookies to analyse visitor traffic and personalise content. The region has 123 health centers and 17 hospitals (one comprehensive referral hospital, four general hospitals, and 12 primary hospitals). Njoku CO, Abeshi SE, Emechebe CI. 2006 Aug;23(6):345-9. doi: 10.1055/s-2006-947158. 2019;126:132. medterms medical dictionary a-z list / grand multipara definition. Geneva: World Health Organization; 2004. The woman would be considered a multipara for this reason. Alshebly MM. Normal purperium physiology Duration. National Library of Medicine Our objectives were to evaluate the management of GMP in contemporary obstetrics and to assess whether grand multiparas are still high-risk patients. A woman considered to be a grand multipara has experienced five or more viable pregnancies lasting longer than 20 weeks. Eugene MI, Abedinego OA. Register your specific details and specific drugs of interest and we will match the information you provide to articles from our extensive database and email PDF copies to you promptly. Grand Multiparity: Risk Factors and Outcome in a Tertiary Hospital: a Comparative Study. 2019 Apr;73(2):92-96. doi: 10.5455/medarh.2019.73.92-96. Create your account. In this study, high incidences of adverse perinatal outcomes occurred among women with grand multiparity. Data were cleaned for missing values and inconsistencies. Dr. Barbara E. Austin, ND, is a doctor of Naturopathy. We recommend that all the stakeholders should give close monitoring for pregnant women with high parity throughout their prenatal, intrapartum, and postpartum periods. Muniro Z, Tarimo CS, Mahande MJ, Maro E, Mchome B. 2009;14(1):233238. 214-294-6100. and transmitted securely. We would like to thank the Pan African University of Life and Earth Sciences Institute, the African Union for financial support, and the University of Ibadan for hosting this Ph.D. program. If a woman undergoes ten or more viable pregnancies, she is known as a great-grand multipara. Family welfare services; methods, counseling. The funding organization had no role in the design of the study and collection, analysis, and interpretation of data, or in writing the manuscript; this was the role of the authors. Privacy Policy The Sidama region has 17 hospitals (12 primaries, 4 general, and 1 comprehensive referral hospital). D.) Increase in prothrombin time. WebManagement In antennal care good nutrition, prophylactic and therapeutic iron and folic therapy to prevent and treat iron and folic acid deficiency anemia is must. 1. Teguete I, Maiga AW, Leppert PC. WHO report. Grand multiparity remains a risk in pregnancy and is associated with an increased prevalence of maternal and neonatal complications (malpresentation, meconium-stained liquor, placenta previa and a low Apgar score) compared with other multiparous women who delivered at Muhimbili National Hospital. Grand multiparous (GMP) defined as parity 5 with single post-caesarean lower segment uterine scar admitted at a gestational age of 37 completed weeks and above were compared to grand multiparous without scar uterus at term. 7. Now customize the name of a clipboard to store your clips. Written informed consent was obtained from each study participant, before data collection procedures. Murphy. Alsammani MA, Jafer AM, Khieri SA, Ali AO, Shaaeldin MA. Qualified and trained health professionals were recruited as data collectors and supervisors. The research was submitted to Pan Africa University Life and Earth Sciences Institute, University of Ibadan, and the University of the Ibadan/University College Hospital, Ibadan Ethics Committee for approval (Ethics committee assigned number_/EC/20/0439). WebOf these, 224 (17.9%) were grand multiparas (GM) defined as mothers of parity greater than or equal to 6. Omole-Ohonsi A, Ashimi A. Further, we recommend that the researchers conduct studies about the effect as early as start to follow up grand multigravida on the adverse perinatal outcomes. As general, 50 resulted in stillbirth (6.1%; 95% CI: 4.68.0), 134 in low birth weight (16.4%; 95% CI: 14.019.1), 88 in admission to NICU (10.8%; 95% CI: 8.713.1), 72 in Apgar score < 7 at 5 minutes (8.8%; 95% CI: 711) and 154 resulted in preterm births (18.9%; 95% CI:16.221.7) in cohort. 1. Ahmed N, Akhter S, Das T. Grand multipara with multiple encounters in a tertiary level hospital of Bangladesh. 2nd ed. The number of antenatal care visits had more than four times (42.5% vs 31.7%, 2=8.1, P=0.005) among multiparous and grand multiparous women, Mansfield. Maternal and neonatal outcomes of grand multiparas over two decades in Mali. It is associated with many medical and obstetrical complications. From its roots, "multi-" means "more than one" and "para" refers to the number of births. 51. When a woman has undergone five or more viable pregnancies, a new medical term is used to describe her experience. BMC Public Health. The source of funding to carry out this research was from Pan African University of Life andEarth Sciences Institute, Pan African University, African Union. Dove Medical Press is part of Taylor & Francis Group, the Academic Publishing Division of Informa PLC 4. Others like the gender of the neonate, birth asphyxia, birth trauma during delivery, and admission to NICU were no association between grand multiparity and multiparity (P> 0.05) (Table 2). 3095 Kingswood Blvd. 31. Al-Obaidly S, Khaldi HM, Emad N, Al-Ibrahim A, Bayo A. Federal Ministry of Healthof Ethiopia. Back to Journals International Journal of Women's Health Volume 14, Effect of Grand Multiparity on the Adverse Birth Outcome: A Hospital-Based Prospective Cohort Study in Sidama Region, Ethiopia, Published 10 March 2022 The highest prevalence of grand multipara women was seen among Muslim community (1.65%). Details of a womans gravidity and parity are important. 972-854-0009. - Definition, Symptoms & Treatment, What Is PID? Statistical Methods for Rates and Proportions. That is why it was selected these hospitals as the study area. 2019;14(6):e0218259. - Definition & History, What Is Menarche? [2]On the other hand, in developed countries with improved and optimal obstetric services, parityper seis no longer considered a significant risk for adverse obstetric and perinatal outcomes. Afzal A, Mahajan N, Firdous N. Pregnancy outcomes in grand multiparous patients: a hospital based study from Jammu and Kashmir, India. [Ethiopia] and ICF, Ethiopia Demographic and Health Survey 2016. It is bordered on the south by the Oromia region with the Gedeo Zone, on the west by the Wolaita Zone, and the north and east by the Oromia region. doi:10.1186/s12884-019-2377-5. World Health Organization; 2004. The number of antenatal care visits had more than four times (42.5% vs 31.7%, 2=8.1, P=0.005) among multiparous and grand multiparous women, respectively. MedicineNet does not provide medical advice, diagnosis or treatment. 41. STATA Version 14 was used for analysis.Results: The overall cumulative incidence of adverse perinatal outcomes was 33% (95% CI: 29.9%, 36.4%). WebINTRODUCTION. In terms of immediate newborn complications, this study showed that there was no statistical difference in the two groups as regards the Apgar< 7 score at 1 minute, birth trauma, birth asphyxia, admission to neonatal intensive care unit, perinatal complication, and sex of newborn. For continuous variables normality distribution was tested applying visual inspection and statistical tests ShapiroWilk tests and we considered as normally distributed if p-value > 0.05. PMC Med Arch. Adverse neonatal outcomes of adolescent pregnancy in Northwest Ethiopia. doi:10.14260/jemds/1318. Grand multiparity remains a risk in pregnancy and is associated with an increased prevalence of maternal and neonatal complications (malpresentation, This finding is consistent with the previous studies which were conducted in Iraq, Jordan, Saudi Arabia, and Ethiopia.14,17,22,30 Conversely, there were no statistically significant differences in adverse perinatal outcomes between grand multiparous and multiparous women as the studies conducted in rural Cameroon and Ethiopia.2,12 The possible explanation might be due to the quality of health care, trained health personnel, and application of different standard protocols for proper management of health care services from pregnancy to delivery.2, The present study revealed that preterm birth was significantly higher among grand multiparous (23.6%). Hailemichael HT, Debelew GT, Alema HB, Weldu MG, Misgina KH. Pelvic assessment should be done as a routine. 50. Each adverse birth outcomes percentages of multiparity versus grand multiparity were displayed below in figure details (Figure 1). In order for a pregnancy to be considered viable, it must have lasted for at least 20 weeks. Women who had grand multiparity (Para 5 to 9) and visited the selected hospitals were the exposure group. Learn More Request Appointment Sultan S, Ojha J. There were no instances of uterine rupture or maternal demise. This finding is similar to the study conducted in Tanzania.7 In some research reports in Jordan, preterm delivery is not associated with grand multiparity.30 The possible explanation might be women get good quality of modern medical and obstetrics services as well they have adequate knowledge on maternal and child health.30, The finding revealed that the risk of stillbirth was higher with grand multiparity. And 17 hospitals ( 12 primaries, 4 general, and 12 primary hospitals.. 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