Grand-multiparity and its impact on delivery outcomes: A ten-year retrospective study at Aminu Kano Teaching Hospital, Kano

Abstract

Background: Grandmultiparity, defined as having given birth to the fifth to ninth child, and great grandmultiparity, involving ten or more childbirths, present obstetric challenges due to their association with high-risk pregnancies. Adverse outcomes can strain resources and healthcare systems. This retrospective study examines the delivery outcomes of grandmultiparous women at Aminu Kano Teaching Hospital over a decade.

Methods: A retrospective analysis covered January 2012 to December 2021, involving women who delivered at the hospital. Data, including socio-reproductive characteristics, mode of delivery, complications, and outcomes, were extracted from records. SPSS version 25 was used for statistical analysis (p < 0.05).

Results: Grandmultiparous women accounted for 8.4% of parturients, primarily aged 30-39 (76.8%) with parity ranging from 5 to 9 (90.9%). Approximately 52% received antenatal care at the hospital or peripheral facilities. Most (73.2%) had spontaneous vaginal deliveries, 25.2% underwent cesarean sections, and 1.6% had instrumental deliveries. Complications included postpartum hemorrhage (27.6%), hypertensive disorders in pregnancy (19.9%), and malpresentation (7.2%). Neonatal outcomes revealed 21.8% low birth weight, 9.6% macrosomic infants, and 6.2% birth asphyxia.

Conclusion: The study highlights that grandmultiparity remains evident among parturients in tertiary hospitals, primarily in older and less educated women. It underscores the need for vigilant antenatal care to mitigate associated risks and improve maternal and neonatal outcomes. Tailored interventions for grandmultiparous women are essential to ensure their well-being and that of their newborns in high-risk pregnancies.