Agrawal Smriti, Agarwal Anjoo, Das Vinita
Department of Obstetrics and Gynecology, Chhatrapati Shahuji Maharaj Medical University, Lucknow, India.
J Obstet Gynaecol Res. 2011 Aug;37(8):1015-9. doi: 10.1111/j.1447-0756.2010.01476.x. Epub 2011 Apr 12.
This study was undertaken to evaluate the impact of grandmultiparity on obstetric outcome in a low resource setting.
MATERIAL & METHODS: Two hundred and eighty-two antenatal grandmultiparous women (parity ≥ 4) were compared with consecutive 564 antenatal women with parity 1-3.
There were 13 403 deliveries over the study period from Jan 2006-December 2008 at CSMMU, Lucknow. The prevalence of grandmultipara was 2.3%. Grandmultipara were older (P < 0.001) and more commonly from rural areas (P < 0.001) as compared to the control group. The percentage of Muslims among grandmultipara (23.8%) was higher than among controls (16.5%), P < 0.01. Grandmultipara had significantly higher prevalence of anemia (P < 0.001), malpresentation (P = 0.01) and rupture uterus (P < 0.001). Abruptio placenta, placenta previa and obstructed labor were seen more often in grandmultipara, and the difference was statistically significant (P < 0.01 in each group). There was no difference in terms of mode of delivery, sex of newborn or the prevalence of low birthweight (<2.5 kg) babies. Stillbirths were more common in grandmultiparas (P < 0.001). There was one maternal death in the study group.
Grandmultiparity continues to be of grave concern with an adverse impact on obstetric and perinatal outcome.
本研究旨在评估在资源匮乏地区，多产次对产科结局的影响。
将282例产前多产次妇女（产次≥4）与连续的564例产次为1 - 3次的产前妇女进行比较。
在2006年1月至2008年12月研究期间，勒克瑙CSMMU有13403例分娩。多产次的患病率为2.3%。与对照组相比，多产次妇女年龄更大（P < 0.001），且更常见于农村地区（P < 0.001）。多产次妇女中穆斯林的比例（23.8%）高于对照组（16.5%），P < 0.01。多产次妇女贫血（P < 0.001）、胎位异常（P = 0.01）和子宫破裂（P < 0.001）的患病率显著更高。胎盘早剥、前置胎盘和产程梗阻在多产次妇女中更常见，差异具有统计学意义（每组P < 0.01）。在分娩方式、新生儿性别或低出生体重（<2.5 kg）婴儿的患病率方面没有差异。死产在多产次妇女中更常见（P < 0.001）。研究组有1例孕产妇死亡。
多产次仍然令人严重担忧，对产科和围产期结局有不利影响。
