Prospective study of maternal and neonatal outcome in great-grand multiparous women (≥10 births) and in aged-matched women with lesser parity.

PURPOSE: Evaluation of outcome of labor/delivery in great-grand multiparous (GGMP) women relative to women with lower parity is complicated because of confounding parity with (older) age. Herein, we compare maternal and neonatal outcome in GGMP from a large obstetrics department to that in older women with lesser parity.

METHODS: This was a prospective observational study of older gravid women. All laboring women in a 6-month period were included in this study if they were older than 36 years and had had 2-3 previous births (low parity) or 5-6 previous births (medium parity), and also all women ≥10 births (of any age); all other laboring women were excluded.

RESULTS: GGMP (187 women) relative to low-parity (128 women) and medium-parity (181 women) had higher mean gestational age (39.72 ± 1.8 vs. 39.1 ± 1.8 and 39.15 ± 1.6 weeks; p = 0.0011), mean dilatation at presentation (5.0 ± 2.0 vs. 4.3 ± 2.1 and 4.36 ± 2.0; p = 0.0074), and mean neonatal birth weight (3444.6 ± 540.8 vs. 2376 ± 507.8 and 3272.3 ± 559.5 g; p = 0.0032). GGMP relative to low- and medium-parity women had lower mean gravidity:parity (1.10 vs. 1.3 and 1.19; p < 0.0001); percent missed abortions (8 vs. 28.1 and 43.1%; p = <0.0001); mean second stage (10.4 ± 12.5 vs. 21.2 ± 26.4 and 12.8 ± 17.3 min; p < 0.0001); mean ratio previous cesarean sections: total potential deliveries (0.03 ± 1.07 vs. 0.16 ± 0.25 and 0.09 ± 0.22; p < 0.0001). The low parity group had the least good maternal and neonatal characteristics. There was no maternal or fetal mortality in any group.

CONCLUSIONS: Among older Israeli GGMP women, maternal and neonatal outcome is good and comparable to women of similar age, but lesser parity.