Maternal And Perinatal Adverse Obstetric Outcomes in Grandmultiparity at Mbarara Regional Referral Hospital
Ssemujju A, Mpiima D, Lugobe H, Kayondo M
Background: Grandmultiparity has been found historically and up to date to be associated with
maternal and perinatal complications. This association has been reported especially in studies done in
developing countries. However recent studies especially in the developed countries find no increased risk
for such adverse obstetric outcomes . This difference has been attributed to the quality and availability
of obstetric care together with level of socioeconomic status. Because of the controversy surrounding
the association of grandmultiparity with adverse obstetric outcomes, it calls for a regional or facility
based assessment on the obstetric performance in grandmultiparity. This study aimed at determining
the association of adverse obstetric outcomes (i.e maternal and perinatal) with grandmultiparity at
Mbarara Regional Referral Hospital.
Methods: This was a cross sectional study of 562 participants including 281 grandmultiparous and
281 multiparous women during a study period of three and half months. Data was collected on sociodemographics, health system, behavioral, maternal medical conditions, past obstetric and gynecological
factors and obstetric outcomes for the current pregnancy including adverse obstetric outcomes of
interest. Frequencies of adverse obstetric outcomes were determined and compared between the
two groups. Univariate and multivariate logistic regression was done to establish the association of
grandmultiparity with adverse obstetric outcomes.
Results: Apart from premature/early rupture of membranes and admission of neonates to pediatric ward
among grandmultiparous women, the rest of the adverse obstetric outcomes were comparable and not
significantly different. After adjusting for potential confounders, there was no adverse obstetric outcome
associated with being grandmultiparous. In fact, being grandmultiparous offered some protection
against perineal tears. Grandmultiparous women had significantly lower odds of experiencing perineal
tears aOR=0.13 (0.063-0.290), p<0.001 compared to multiparous women
Conclusion: Grandmultiparity at Mbarara Regional Hospital does not carry increased risk for adverse
maternal and perinatal outcomes in comparison to low parity multiparous women.
