Grand multiparity in rural Cameroon: prevalence and adverse maternal and fetal delivery outcomes.

BACKGROUND

Grand multiparity is a major public health concern especially among developing countries and has been associated with higher risk of adverse maternal and fetal outcomes compared with women of lesser parity. There is a dearth of evidence on this subject in Cameroon, especially in the rural areas. We therefore carried out this study to document the prevalence and maternal and fetal delivery outcomes of grand multiparity in a rural Cameroonian setting.

METHODS

We conducted a retrospective chart review of delivery records from two health facilities (the Oku District Hospital and Kevu Integrated Health Centre) in the Oku Health District over a period of eight years. Data was entered into and analyzed using Epi-Info version 7.0.8.3. The Chi-squared or Fisher's exact test was used to compare categorical variables. The threshold of statistical significance was set at 5%.

RESULTS

A total of 1755 delivery records met our inclusion criteria. The overall prevalence of grand multiparity was 27.0%. We found no significant difference in the rate of selected maternal and fetal delivery outcomes between grand multiparous women and those with lesser parity (p-value> 0.05). However, grand multiparous women were less likely to develop second-fourth degree perineal tears compared to their counterparts with lesser parity (odds ratio = 0.3, 95% confidence interval = 0.2-0.7, p = 0.001).

CONCLUSION

Our study depicts a high prevalence of grand multiparous delivery in this rural community. With the exception of severe perineal tear, grand multipara and their babies are as likely to develop adverse delivery outcomes as their counterparts with lesser parity. There is also the need to enhance existing government policies on reproductive health in rural areas.