impact of parity on obstetric and neonatal outcome

This study was carried out to evaluate the obstetric and perinatal outcome of grandmultiparous women, and to compare it to that of nongrandmultiparous women. Between January 1993 and June 1994, there were 10223 deliveries of twenty eight weeks and more at Prince Rashed Ben AI-Hassan Hospital, of which 2201 were to grandmultiparous women. The pregnancy out-come of both grandmultiparous and nongrandmultiparous women were compared and analyzed. The comparison of grandmultiparous women with the nongrandmultiparous, revealed no significant differences in the incidence of instrumental deliveries, ante- and post partum hemorrhage, malpresentations, diabetes, hypertension, fetal distress, neonatal deaths and stillbirths. Cesarean section rate, congenital malformations, multiple pregnancies and anemia were more common in grandmultiparous women than in the other group. Prolonged labor, preeclampsia and eclampsia, low birth weight babies and premature babies were more common in nongrandmultiparous women with significant statistical differences. Conclusions: Grandmultipara is not a major risk factor and it does not carry an increased risk of obstetric and perinatal mortality and morbidity

Maternal age and pregnancy outcome

This study was carried out to evaluate the risk factors associated with advanced maternal age, and to analyse the relationship between maternal age and the outcome of pregnancy. Method: Over a two- year period [Jan.1993 to Jan. 1995], there were 14615 deliveries after pregnancies of >/= 28 weeks duration at Prince Rashed Ben AI-Hassan Hospital in Irbid, of which 544 pregnant patients were above the age of 40 years. The pregnancy outcome as well as cesarean section rate, malpresentations, multiple pregnancies, antepartum haemorrhage, hypertension, prematurity, fetal distress, stillbirth, neonatal death, fetal congenital abnormalities, small for dates, and large for dates babies of this group were compared with that of the age group below 40. Significant statistical differences were found between the above- and below- 40 year age groups in many of the parameters which include: Cesarean section rate 23.8% versus 5.3% [P<0.001], breech and transverse malpresentations 9.9% versus 3% and 1.8% versus 0.2%, respectively [P<0.001], antepartum haemorrhage 2.2% versus 0.9% [P<0.001], placenta praevia 4.6% versus 0.3% [P<0.001], abruptio placenta 2.7% versus 0.5% [P<0.001], stillbirth 2.31% versus 0.6% [P<0.001], Down's syndrome 1.9% versus 0.1% [P<0.001] and small for dates 6.3% versus 3.6% [p<0.001].This study showed that the increased maternal age is associated with the increased obstetric and perinatal risk in comparison with other age groups. Pre-pregnancy counseling and intensive antenatal assessment is mandatory