http://dx.doi.org/10.5455/2320-1770.ijrcog20150207 Volume 4 · Issue 1 Page 38 International Journal of Reproduction, Contraception, Obstetrics and Gynecology Alsammani MA et al. Int J Reprod Contracept Obstet Gynecol. 2015 Feb;4(1):38-42 www.ijrcog.org pISSN 2320-1770 | eISSN 2320-1789 Research Article Obstetric complications and neonatal outcome of grandmultiparity: A comparative study Mohamed Alkhatim Alsammani 1,2 *, Salah Roshdy Ahmed 1,3 INTRODUCTION Grand multiparity has been considered an independent factor for increasing adverse outcome for both fetus and mother specially diabetes mellitus, antepartum hemorrhage, malpresentation, cesarean section rate, postpartum hemorrhage, iron deficiency anemia, and a high perinatal mortality rate Al JF. 1 More recent reports, however, have demonstrated that in the presence of good perinatal care, grand multiparity no longer need to be considered an obstetrical risk in the presence of satisfactory health care conditions. 2,3 The majority of the studies argued that grandmultiparas are more likely to be of old age which might be the reasons for increased morbidity and mortality. In our clinical practice, such factor is difficult to be removed because women's age is the most important biological variable that influences the reproductive events which we study. In Saudi Arabia, large family is desirable for cultural reasons; consequently, a high incidence of grand multiparity is expected. The Fertility rate in Saudi Arabia was last reported at 2.81 in 2010, according to a World Bank report published in 2012. 4 In addition, early age of marriage might be one of the reasons for this high incidence of grand multiparas. The current study was conducted in a tertiary hospital where medical care is given free of charge for all mothers. The aims of the 1 Department of Obstetrics & Gynecology, College of Medicine, Qassim University, Saudi Arabia 2 Department of Obstetrics & Gynaecology, College of Medicine, Bahri University, Sudan 3 Department of Obstetrics & Gynecology, College of Medicine, Sohag University, Egypt Received: 04 November 2014 Accepted: 10 December 2014 *Correspondence: Dr. Mohamed Alkhatim Alsammani, E-mail: mailm_sammani@yahoo.com, m_sammani@yahoo.com Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. ABSTRACT Background: The aim of the current study was to determine the prevalence of grand multiparity and the associated risks factors. Methods: Four hundred thirty grand mutliparas (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 = 0.048), 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 = 0.032). 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 multiparity 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. Keywords: Grand multiparity, Pregnancy outcome, Obstetric complications, Neonatal morbidity DOI: 10.5455/2320-1770.ijrcog20150207