Grandmultiparity - not to be feared? An analysis of grandmultiparous women receiving modern antenatal care

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Abstract
To document the reproductive performance of grandmultiparous women receiving modern antenatal care. A cross-sectional study of 2784 multiparous (882 grandmultiparous) mothers delivered in a base hospital obstetric unit staffed by western-trained midwives and consultant obstetrical staff. There were minimal differences in major antenatal, peripartum and neonatal outcome events, with the exception of a high rate of gestational and pre-existing diabetes. This data supports the opinion that grandmultiparity per se is not necessarily a major risk factor for either mother or fetus. Similarly, the mature grandmultigravida in this population was not at significantly increased risk of the alleged associations of increased parity and advancing maternal age, with the exception of diabetes. Together with the combined prevalence of maternal anemia this requires further investigation and probable intervention, particularly in the light of recent speculation concerning the fetal and infant origins of adult disease.

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