Maternal and neonatal outcomes in grand multiparous women delivered at a tertiary hospital in Niger-Delta, Nigeria.

Ozori ES1*, Fumudoh E1, Makinde OI1, Oriji PC1
1Department of Obstetrics and Gynaecology, Federal Medical Centre, Yenagoa, Bayelsa State, Nigeria.
*Correspondence: Dr. Ozori, Ebiogbo Stanley; + 234 806 587 6000; ozoriniseod@yahoo.com

Download full article in pdf format

Abstract

Background: Total fertility rate in Nigeria is high at 5.3 children per woman, meaning that many women will become grand multiparous at some point during their reproductive career. Grand multiparity is associated with high risk pregnancies and increases the risk of pregnancy associated complications.
Objective: To describe the maternal and neonatal complications and the determinants in grand multiparous women in a tertiary hospital in Niger-Delta, Nigeria.
Materials and Methods: A retrospective descriptive study. Data on grand multiparous women who delivered at the Federal Medical Centre, Yenagoa was collected between 1st of January, 2014 and 31st of December, 2018 using a Proforma. The data was analysed using the Statistical Package for Social Sciences version 20.0.
Results: There were 654 deliveries by grand multiparous women out of 6,435 total deliveries during the period, giving an incidence of 10.2%. Most of the women (37.8%) were aged between 31 and 35 years and had a secondary level of education (42.4%). About 65.3% were booked for antenatal care. Antenatal, labour and foetal/neonatal complications occurred in 31.8%, 29.1%, and 57.2% of the women respectively. Foetal malpresentation was the commonest (31.6%) maternal antenatal complication while the most common maternal labour complication was caesarean delivery (89.5%). There were considerably higher maternal labour complications among unbooked than booked women (65.8% and 34.2% respectively). Unbooked women also had more foetal complications than the booked women (63.3% and 36.6% respectively). Birth asphyxia and perinatal death were more common among the unbooked women.
Conclusion: Poor embrace of tertiary education may have contributed to the number of younger aged grand multiparous women. Grand multiparity is a harbinger of maternal, foetal and neonatal complications and an unbooked status worsens pregnancy outcome in them.

Cite this article: Ozori ES, Fumudoh B, Makinde OI, Oriji PC. Maternal and neonatal outcomes in grand multiparous women delivered at a tertiary hospital in Niger-Delta, Nigeria. Yen Med J. 2020;2(2):38–46.

REFERENCES

  1. Dutta DC. Special Cases; Grand Multipara. In: Konar H, ed. Dc Dutta’s Textbook of Obstetrics including Perinatology and Contraception. 7th ed. New Delhi, India: Jaypee Brothers Medical Publishers (P) Ltd; 2013:342.
  2. Aragaw YA, Mahtermsilllasie M, Jarso H. Grandmultiparity and pregnancy related complications among women who gave birth at Jimma University Specialized Hospital, Jimma, Southwest Ethiopia. Gynecol Obstet (Sunnyvale). 2017;7(4):438. doi:10.4172/2161-0932.1000438
  3. Njiru J, Biryabarema C, Kagawa M. Fetal outcomes among grand multiparous and multiparous women in Mulago hospital, Uganda. East Afr Med J. 2013;90(3):84–88.
  4. Severinski NS, Mamula O, Severinski S, Mamula M. Maternal and fetal outcomes in grand multiparous women. Int J Gynaecol Obstet.2009;107(1):63–64. doi:10.1016/j.ijgo.2009.05.
  5. Okogbenin SA, Eugene O. Parity and Reproductive outcome. In: Okpere E, ed. Clinical Obstetrics. Revised ed. Benin, Nigeria: University of Benin Press; 2007: 402.
  6. Muniro Z, Tarimo CS, Mahande MJ, Maro E, Mchome B. Grand multiparity as a predictor of adverse pregnancy outcome among women who delivered at a tertiary hospital in Northern Tanzania. BMC Pregnancy Childbirth. 2019;19(1):222. doi:10.1186/s12884-019-2377-5
  7. Omole-Ohonsi A, Ashimi AO. Grand multiparity: obstetric performance in Aminu Kano Teaching Hospital, Kano, Nigeria. Niger J Clin Pract. 2011;14(1):6–9. doi:10.4103/1119-3077.79231
  8. Duria AR, AbdelAziem AA, Ameer AO, Ishag A. Maternal and perinatal outcomes of grandmultiparity in Kassala hospital, Eastern Sudan. Khartoum Med J. 2011; 4(1): 554-557.
  9. National population commission (NPC) [Nigeria], ICF. Nigeria Demographic and Health Survey. 2018. Abuja, Nigeria and Rockville, Maryland, USA: NPC and ICF;2019.
  10. Ogbe AE, Ogbe BP, Ekwempu C. Obstetric outcome in Grandmultiparous women in Jos University Teaching Hospital. Jos J Med. 2012;6(2):39-43.
  11. Azuibuike IJ, Ibrahim IA, Isreal J. Grandmultiparity: Incidence, consequences and outcomes in the Niger delta of Nigeria. Open J Obstet Gynecol. 2013;3:509-513.
  12. Lumbiganon P, Laopaiboon M, Panamonta M, Pothinam S. Factors associated with failure to receive antenatal care. Aust N Z J Obstet Gynaecol.1991;31(4):307–310. doi:10.1111/j.1479-828x.1991.tb02808.x
  13. Eze JN, Okaro JM, Okafor MH. Outcome of pregnancy in the grandmultipara in Enugu, Nigeria. Trop J Obstet Gynaecol. 2006;23(1):8- 11.
  14. Akani CI, Pepple DK. Obstructed labour, barrier and bridges in the Niger delta region of Nigeria. Nig Q J Hosp Med. 2004;14(1):21- 25.
  15. Ogedengbe OK, Ogunmokun AA. Grandmultiparity in Lagos, Nigeria. Niger Postgrad Med J. 2003;10(4):216–219.
  16. Osegi N, Makinde OI. Towards optimizing caesarean section: a five-year review of Caesarean sections at a Southern Nigeria hospital. Int J Reprod Contracept Obstet Gynecol. 2020;9(1):205-211.
Scroll to Top
× Chat