Pregnancy outcome among grand multiparous women at the University of Maiduguri Teaching Hospital: a case control study.

Grand multiparity has been described as an independent risk factor for a variety of obstetric complications, especially in developing countries with inadequate health facilities. This case control study compares the pregnancy outcomes of grand multiparas with that of multiparas at the University of Maiduguri Teaching Hospital over a period of 1 year. The labour ward records and patients' case notes were used to extract information. Multivariate analysis created a model of the adverse factors that were independently associated with grand multiparity after control for confounding effects of age and other variables. During the period of study, there were 1,865 deliveries, out of which 350 were grandmultiparas, a rate of 18.8%. Out of the 350 grandmultiparas, 91 were excluded, leaving 259 (74%) patients which were used for the study. The multivariate analysis shows that compared with the multiparas, the grand multiparas were more likely to be uneducated, have abruptio placentae, precipitate labour and stillbirth but were less likely to have prolonged labour, episiotomy, placenta praevia, require operative deliveries or be anaemic at booking. Grandmultiparity was found to be associated with adverse pregnancy outcome. This finding has implications for practitioners caring for these women in our environment.