Peripartum complications in grand multiparous women: para 6-9 versus para≥10

Eli Maymon, Fabio Ghezzi, Ilana Shoham-Vardi, Rely Hershkowitz, Massimo Franchi, Miriam Katz, Moshe Mazor

Research output: Contribution to journalArticlepeer-review

23 Scopus citations


Objective: To assess the importance of birth order and advanced maternal age on maternal and peripartum complications. Study design: The study population consisted of 12 296 multiparous women (six deliveries or more) with singleton gestation. Patients were classified into two groups according to the birth order: grand multiparous (between six and nine deliveries) and huge multiparous (ten or more deliveries). Peripartum complication was defined when at least one of the following conditions occurred: massive hemorrhage, uterine rupture, abruptio placentae, dysfunctional labor or malpresentations. Logistic regression analysis was used to evaluate the relationship between birth order and maternal age and peripartum complications. Results: Among the study population, 9587 (78%) were grand multiparous and the remaining 2709 were huge multiparous women. The rate of peripartum complications was higher in huge multiparous than in grand multiparous women: malpresentation (6.2% versus 5%, P<.005), massive hemorrhage (0.7% versus 0.4%, P<.001) and dysfunctional labor (6.4% versus 3.5%, P<.001). Huge multiparous women also had a higher rate of the following complications than grand multiparous women: cesarean section (14.4% versus 10.4%, P<.01), chronic hypertension (7.9% versus 3%, P<.001), severe pregnancy induced hypertension (2.6% versus 1.1%, P<.01), diabetes class A (10.7% versus 7.5%, P<.005), diabetes class B-R (4.3% versus 2%, P<.01) congenital anomalies (3.3% versus 2.6%, P<.05) and large for gestational age infant, (17% versus 12.4%, P<.01). When adjusted for maternal age, high birth order remained strongly associated with the occurrence of peripartum complications. Conclusions: Huge multiparity was associated with a higher rate of maternal and peripartum complications than grand multiparity. Higher birth order remained an independent risk factor for peripartum complications after adjustment for maternal age. Copyright (C) 1998 Elsevier Science Ireland Ltd.

Original languageEnglish
Pages (from-to)21-25
Number of pages5
JournalEuropean Journal of Obstetrics and Gynecology and Reproductive Biology
Issue number1
StatePublished - 1 Oct 1998


  • High birth order risk factor
  • Multiparous women
  • Peripartum complications

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology


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