THE CLINICAL OUTCOME IN PREGNANCIES OF GRAND GRAND MULTIPAROUS WOMEN

Objective. To longitudinally evaluate maternal and neonatal complicati ons with relation to birth order, with specific emphasis on grand gran d multiparity (at least 10th para). Methods. The maternal and neonatal outcome of 1200 pregnancies/deliveries in 96 grand grand multiparas w as longitudinally investigated in 4 stages of the mothers' life: the p rimiparas, the multiparas (2nd-5th paras), the grand multiparas (6th-9 th paras) and the grand grand multiparas stage. Results. The frequency of hypertension, diabetes, placental complications, operative interve ntions al delivery, macrosomic infants, chromosomal abbreviations and fetal/neonatal anomalies increased with increasing birth order, being at a maximum in grand grand multiparas. The preterm delivery and perin atal mortality rate did not differ between the 3 groups of multiparas. Perinatal outcome was good in each group. Conclusions. Grand grand mu ltiparity carries the risk of hypertensive and diabetic complications, which, in turn, often lead to induced or operative deliveries and pla cental complications. However, grand grand multiparity is not a major problem in societies with a good maternal health care system.