Since this was a referral hospital-based study, our results may not be generalizable to the general population of Tanzania. Advanced maternal age (AMA) has been reported as a major risk factor in developing other maternal conditions including hypertension, diabetes mellitus, renal diseases, and other chronic infections which in turn are associated with PROM [18, 19]. Opara EI, Zaidi J. https://doi.org/10.1186/s12884-016-1016-7. 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. 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. Although the GMP proportion has decreased over years, our result reveals a rather gradual decline of GMP overtime. Factors associated with postpartum hemorrhage with vaginal birth. Definition of MULTIPARITY in the Definitions.net dictionary. Solomons B. 2017;7(7):707–18. Trend of GMP among women who delivered at KCMC from 2006 to 2014 was seen to decrease over years. Incorporated: 1934 What does MULTIPARITY mean? 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. Extreme grand multiparity: is it an obstetric risk factor? The prevalence of grand multiparity in this study was consistent with a study done in Saudia by Alsammamiet al which reported a prevalence of 5.3% [15]. Although there is variation in each year, the proportion in the year 2006 (9.72%) and 2007 (9.03%) are rather similar. Part of Other patients’ information is entered and kept in various registers at each service delivery points such as theater rooms, labor ward, Intensive Care Unit (ICU) and in the antenatal and postnatal units. Ethical approval was obtained from Kilimanjaro Christian Medical University College Research Ethics Committee with reference number 971. Drife J. https://study.com/academy/lesson/multipara-definition-risks.html Bugg GJ, Atwal GS, Maresh M. Grand multiparae in a modern setting. Available from. Furthermore, the International Federation of Gynecology and Obstetrics defined GMP as deliveries of a fifth to ninth, while naming those undergoing their tenth or more deliveries as great grand-multiparous or huge great grand-multiparous [5,6,7,8]. Obstet Gynecol. In the UK: Gravidityis defined as the number of times that a woman has been pregnant. lnt J Gynecol Obstet, 1991, 36: 13-16 International Federation of Gynecology and Obstetrics Grand multiparity: a reappraisal of the risks P.A. — multiparous, adj. The crude and adjusted analysis for the association between grand multiparity and adverse pregnancy outcomes are displayed in Table 3 and Table 4 respectively. What is the abbreviation for Grand Multiparity? Among other factors, grand multiparity is hypothesized to play a significant role in adverse maternal outcomes especially in low-and-middle income countries like Tanzania. 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). Above all, we appreciate all mothers who consented to be part of this study. 2013;(67):1–18. BJOG An Int J Obstet Gynaecol. Studies have examined predictors of intention to use modern contraceptives among women of reproductive age. Despite the strengths, there were some limitations that should be considered while interpreting findings from this study. Similar findings were reported by Combs et al who studied women from the United States [22]. grand multipara a woman who has had six or more pregnancies that resulted in viable offspring. (See 'Variability in the definition of parity' below.) Available from: https://www.globalfinancingfacility.org/sites/gff_new/files/Tanzania_One_Plan_II.pdf. volume 19, Article number: 222 (2019) The interpretation and clinical application of the word “parity”: a survey. 2004;104(1):71–7. 1. Information on the neonates who are admitted in the neonatal care unit were recorded in neonatal registry forms. The increase use of contraceptives and improved health care delivery is expected to reduce both the prevalence and complications of this condition. However, in contrast, several other studies elsewhere have clearly shown GMP to be a risk factor for PPH [17, 20, 23]. Asian Pacific J Reprod 2016;5(3):214–220. Look it up now! J Med Trop. 1984;150(8):965–72. Great grand multipara have been reported to have an increased incidence in obstetric complications such as fetal malpresentation, placental abruption, … n, pl -rae (-ˌriː) (Gynaecology & Obstetrics) a woman who has given birth to more than one viable fetus or living child. grand multiparity (grand multi-pa-riti) n.the condition of a woman who has had five or more previous pregnancies. 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. After data extraction from the main database, data were cleaned, checked for consistency and verification of missing values. 2002;101(1):22–5. Placental issues, including placenta previaand placental abruption 5. Cite this article. Chandra A, Copen CE, Stephen EH. GR…, 11-12 Hanover Square From this data set a large sample size was obtained thus giving the study more power and making it possible to adjust for confounders as well as making inference in similar settings with high precision. Like gravidity, parity may also be counted. 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 Trend in grand-multiparity was determined by calculating yearly proportions and displayed using a line graph. Grand multiparity may either be a marker for or a cause of poor nutrition. Ma Department of Obstetrics and Gynaecology, Universitv of Hong Kong (Hong Kong) (Received April 16th, 1990) (Revised and accepted August 15th, 1990) Abstract An excellent maternal and perinatal outcome is reported in a … Low birth weight (LBW) was defined as a birth weight of less than 2500 g with gestational age of ≥28 weeks. 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. 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]. Moreover, we aimed at assessing the prevalence, trend and associated pregnancy outcomes of grand multiparity in a tertiary hospital in Northern Tanzania over nine (9) years. Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. This could be the case in the present study. Omole-Ohonsi A, Ashimi AO Niger J Clin Pract 2011 Jan-Mar;14(1):6-9. doi: 10.4103/1119-3077.79231. We also found that GMP was significantly associated with an increased risk of PPH when controlled by maternal age and educational level attainment. Emechebe C, Njoku C, Eyong E, Maduekwe K, Ukaga J. the condition or process of producing more than one offspring at one birth. Approximately half (52%) of the grand multiparous subjects had less than 4 antenatal care visits during their pregnancy while 60% delivered at term. Precipito… Miller-Keane Encyclopedia and Dictionary of Medicine, Nursing, and Allied Health, Seventh Edition. 1995;172(1):683–6. 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. Therefore, that information is unavailable for most Encyclopedia.com content. California Privacy Statement, Prevalence of grand multiparity was 9.44%. Adverse pregnancy outcomes associated with grand multiparity were estimated using multivariable logistic regression models. Schematic Diagram of the selected study participants. Google Scholar. 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 order to document the consent process, the birth registry has an instruction manual for registration of deliveries in the registry. Refer to each style’s convention regarding the best way to format page numbers and retrieval dates. 1997;259:179–87. ny • n. Law (in many U.S. states and formerly in Britain) theft of personal property having a value above a legally specified amount. © 2020 BioMed Central Ltd unless otherwise stated. Despite efforts to reduce maternal and perinatal adverse outcomes in Tanzania, maternal morbidities and mortalities are high. Therefore, be sure to refer to those guidelines when editing your bibliography or works cited list. 2002;109(3):249–53. 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. 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]. A total of 18,441 deliveries were analyzed. The authors declared to have no competing interests. This was a cross-sectional study using maternally linked data from Kilimanjaro Christian Medical Centre (KCMC) medical birth registry. Moreover, describing a trend of grand multiparity overtime may provide a reflection of effectiveness of contraceptive coverage in this population. Descriptive statistics were summarized using frequency and percentages for categorical variables. This study’s primary aim was to determine the association between GMP and adverse pregnancy outcome. Hoque M, Hoque E, Kader SB. Grand Multiparity and its Obstetrical Complications at Bahawal Victoria Hospital Bahawalpur 707 P J M H S Vol. Macrosomia(an unusually large fetus that may be unable to fit through the mother’s pelvis) 4. 1999;181(3):669–74. We therefore recommend future prospective study to explore the association of GMP with maternal mortality. 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. The lower prevalence in this study can be attributed to standard literacy level of grand multiparas, as over 52% had at least primary level of education. Women with singleton deliveries from 2006 to 2014 were analyzed. 8, NO. Our result is consistent with previous studies done in Nigeria that describe a 3.6–4.2% increase in PROM in grand multiparas as compared to multiparas [16, 17]. 01-629-7488 Multiparity definition at Dictionary.com, a free online dictionary with pronunciation, synonyms and translation. Employees: 137,195 Grand multiparity and low contraceptive prevalence are dominant among Nigerian women. Some literature define it as a woman who delivered four or more times while others consider of six or more deliveries [4]. The National Road Map Strategic Plan to Improve Reproductive, Maternal, Newborn, Child and Adolescent Health in Tanzania (2016–2020) (One Plan II). Grand multiparity is therefore a serious public health issue in Cameroon, particularly in rural zones. 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. This study found that grand multiparity was associated with maternal and perinatal complications such as prelabour rupture of membranes, stillbirth and preterm birth. 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. 2016. The main outcome variables include prelabour rupture of membranes (PROM), postpartum hemorrhage (PPH), pre-eclampsia, low birth weight, stillbirth and preterm birth. In addition to the MLA, Chicago, and APA styles, your school, university, publication, or institution may have its own requirements for citations. Z64.1 is a billable code used to specify a medical diagnosis of problems related to multiparity. This is in consistent with study done by Selo-Ojemeet al among Nigerian women [21]. Sales: £5.287 billion (US$7.772 billion)…, GRAND PRAIRIE Objective: To determine the social class and reasons for grand multiparity in Calabar. The prevalence of grand multiparity at the institution over nine years found was found to be 9.44%. This manual contains the standard operating procedures on how to conduct the interview and also has a description of the basic rules including ethical guidelines such as consent process. Cookies policy. Springer Nature. England This study takes advantage of existing large scale birth registry data to reaffirm existing small scale evidence conducted in 2013 in one of the tertiary facility in Tanzania and attempt to account for change in magnitude of grandmultiparity overtime with an additional capability to capture infrequent adverse outcome. For example, a woman who is described as 'gravida 2, para 2 (sometimes abbreviated to G2 P2) has had two pregnancies and two deliveries after 24 weeks, and a woman who is described as 'gravida 2, para 0' (G2 P0) has had two pregnancies, neithe… To minimize the confounding effect of the socioeconomic status, the outcome of grand multiparity has been investigated in a mostly homogeneous, ultraorthodox Jewish community in Jerusalem, Israel. 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. A p-value of less than 0.05 (2-tailed) was considered statistically significant. PIP: Grand multiparity has been considered to be a factor in maternal and neonatal morbidity. Ananth CV, Oyelese Y, Srinivas N, Yeo L, Vintzileos AM. This trend may pose substantial risk to the pregnant mother and result in adverse birth outcome. Jos J Med. In this test, all pregnancy outcomes assessed in the study were significantly associated with parity status of participants. Hence, it may suffice to say that, in this population, PPH is well explained by GMP condition, maternal age and education level. All authors have read and approved the final manuscript. 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. Maro EW, Mosha NR, Mahande MJ, Obure J, Masenga G. Asian Paci fi c journal of reproduction a descriptive retrospective tertiary hospital-based study. 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By using this website, you agree to our Terms and Conditions, California Privacy Statement and Cookies policy hospital!, data were collected from these women with singleton deliveries from 2006 to 8.49 % in 2014 2010 26! Ashimi AO Niger J Clin Pract 2011 Jan-Mar ; 14 ( 1 ) doi. Should be considered while interpreting findings from this study aimed to determine the association between a set of maternal outcomes! Multiparity and poor acceptance of modern family planning methods women in North-Tanzania was 9.44.. Each pregnant woman attending this facility has her history documented on patient with...