GRANDMULTIPARITY - NOT TO BE FEARED - AN ANALYSIS OF GRANDMULTIPAROUSWOMEN RECEIVING MODERN ANTENATAL CARE

OBJECTIVE: To document the reproductive performance of grandmultiparou s women receiving modern antenatal care. METHODS. A cross-sectional st udy of 2784 multiparous (882 grandmultiparous) mothers delivered in a base hospital obstetric unit staffed by M,Western-trained midwives and consultant obstetrical staff. RESULTS: There were minimal differences in major antenatal, peripartum and neonatal outcome events, with the exception of a high rate of gestational and pre-existing diabetes. CON CLUSIONS: This data supports the opinion that grandmultiparity per se is not necessarily a major risk factor for either mother or fetus. Sim ilarly, the mature grandmultiparity in this population was not at sign ificantly increased risk of the alleged associations of increased pari ty and advancing maternal age, with the exception of diabetes. Togethe r with the combined prevalence of maternal anemia this requires furthe r investigation and probable intervention, particularly in the light o f recent speculation concerning the fetal and infant origins of adult disease.