2017;7(7):707–18. This TPAL form indicates five pregnancies, with three term births, one preterm birth, one induced abortion or miscarriage, and four living children. The chi-square test for linear trend showed that, there appears to be a statistically significant trend in prevalence of grand multiparity over years (p < 0.001). Among other factors, grand multiparity is hypothesized to play a significant role in adverse maternal outcomes especially in low-and-middle income countries like Tanzania. Zainab Muniro. A "nulligravida" is a woman who has never been pregnant. The datasets during the current study are not publicly available to protect the participants’ anonymity. A "primigravida" is a woman who is pregnant for the first time or has been pregnant one time. The prevalence of grand-multiparity was computed as proportion to estimate the trend over years. Some literature define it as a woman who delivered four or more times while others consider of six or more deliveries [4]. Grand Multiparity : obstetric outcome in comparison with multiparous women in a developing country. Opara EI, Zaidi J. The final sample analyzed comprised of 18,441 deliveries (Fig. This is in consistent with study done by Selo-Ojemeet al among Nigerian women [21]. This study found that grand multiparity was associated with maternal and perinatal complications such as prelabour rupture of membranes, stillbirth and preterm birth. CAS  Introduction. Hoque M, Hoque E, Kader SB. Descriptive statistics were summarized using frequency and percentages for categorical variables. Correspondence to The study comprised of 150 grand-multiparous women (cases) and 150 multiparous women (para 2 - 4) in this index pregnancy as controls matched for age and admitted for delivery. Following consent, the mother could still choose not to reply to single question. Cookies policy. The objective was to compare the obstetric outcome of grand-multiparous women with that of low parity in our center. https://study.com/academy/lesson/multipara-definition-risks.html Jos J Med. BJOG An Int J Obstet Gynaecol. 1). However, other definitions are … Alsammani M, Ahmed S. Grand multiparity: risk factors and outcome in a tertiary hospital: a comparative study. © 2003 by Saunders, an imprint of Elsevier, Inc. All rights reserved. This study’s primary aim was to determine the association between GMP and adverse pregnancy outcome. This study aimed to determine prevalence, trend and associated adverse pregnancy outcomes of grand multiparity in a tertiary hospital in Northern Tanzania. Despite the strengths, there were some limitations that should be considered while interpreting findings from this study. We excluded multiple pregnancy to avoid overrepresentation of high-risk women which might exaggerate the pregnancy outcomes. A verbal consent to publish individual details (information) were provided by each of the study participants after being explained about the objectives of the medical birth registry and the benefits of the data generated to be shared to the public. BJOG An Int J Obstet Gynaecol. Multiparity definition at Dictionary.com, a free online dictionary with pronunciation, synonyms and translation. Pregnancy complications of grand multiparity at a rural setting of South Africa. Hence, it may suffice to say that, in this population, PPH is well explained by GMP condition, maternal age and education level. Google Scholar. Multipara definition, a woman who has borne two or more children, or who is parturient for the second time. Antepartum hemorrhage and postpartum hemorrhage (for more information, see our page on maternal bleeding) 2. In addition, maternal mortality, as one of the important outcomes was not investigated in this study due to insufficient information regarding maternal deaths in the dataset. By using this website, you agree to our Asian Pacific J Reprod 2016;5(3):214–220. The study warrants more emphasis to be directed towards community sensitization on the adverse maternal and fetal outcomes that might be attributable to GMP. BMC Pregnancy and Childbirth It includes women who have experienced spontaneous miscarriages and induced abortions before the mid-point of pregnancy, but not women who have experienced pregnancy loss after 20 weeks. Ministry of Health Community Development Gender Elderly and Children. http://dx.doi.org/10.4314/tjog.v23i1.14555, https://doi.org/10.1016/j.apjr.2016.04.012, http://www.tjogonline.com/text.asp?2016/33/3/327/199808, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4610637/, https://www.globalfinancingfacility.org/sites/gff_new/files/Tanzania_One_Plan_II.pdf, https://doi.org/10.1186/s12884-016-1016-7, http://creativecommons.org/licenses/by/4.0/, http://creativecommons.org/publicdomain/zero/1.0/, https://doi.org/10.1186/s12884-019-2377-5, Pregnancy and childbirth in low and middle income countries. The highest proportion was appreciated in the year 2011 (10.38%) followed by 7.85, 9.43 and 8.49% in the years 2012, 2013 and 2014 respectively (Fig. PubMed Google Scholar. KCMC is a referral consultants and teaching hospital located in Moshi, Kilimanjaro region in Northern-Tanzania. Article  BJOG An Int J Obstet Gynaecol. A woman who has given birth one or more times can also be referred to as para 1, para 2, para 3, and so on. Grand multiparity remains a risk in pregnancy and is associated with an increased prevalence of maternal and neonatal complications (malpresentation, meconium-stained liquor, placenta previa and a low Apgar score) compared with other multiparous women who delivered at Muhimbili National Hospital. 2007;114(10):1295–7. Toohey JS, Keegan KA, Morgan MA, Francis J, Task S, deVeciana M. The “dangerous multipara”: fact or fiction? Grand-multiparity (GMP) condition has been defined differently in several literature [ 1, 2, 3 ]. For other uses, see. D. Vecchio, G. Neglia, M. Rendina, M. Marchiello, A. Balestrieri, R. Di Palo (2007). This could be explained by the fact that since AMA is a major risk for various maternal complications, thus fetus and neonates may always be susceptible to mortality and morbidity. Conclusion: Grand multiparity remains a risk in pregnancy and is associated with an increased prevalence of maternal and neonatal complications (malpresentation, meconium-stained liquor, placenta previa and a low Apgar score) compared with other multiparous women who delivered at … Grand-multiparity (GMP) condition has been defined differently in several literature [1,2,3]. 2) Related to a multipara. Afolabi AF, Adeyemi AS. Google Scholar. Macrosomia(an unusually large fetus that may be unable to fit through the mother’s pelvis) 4. We compared the maternal and perinatal complications among grand multiparous … The dangerous multipara. Obstet Gynaecol. Published by BMC pregnancy and childbirth, 01 January 2018 rupture (0.67% of sample) were recorded. 2010;6(2):39–43. When fetal outcomes were adjusted for the same factors, stillbirth (AOR 1.66; 95% CI: 1.31–2.11) and preterm birth (AOR 1.28; 95% CI: 1.05–1.56) remained statistically significant factors associated with GMP (Table 4). The term "gravida" can be used to refer to a pregnant woman. Information for all deliveries that occur at the department of Obstetrics and Gynecology are prospectively collected and entered in a computerized database system at the medical birth registry. The study also suggests a need for establishment of a referral system unit at this institution that will be specifically managing deliveries occurring in women with high parity as well as advanced age. grand multiparity and maternal outcome in absence of adequate antenatal care Breast-feeding initiation rates in the multiparous women (7.5%) were more than primis (2.2%) with a significant p value. Trained midwife nurses conduct interviews on daily basis using a standardized questionnaire for all women who deliver at the hospital within 24 h of delivery or immediately after recovery from a complicated delivery. A woman who has given birth 5 or more times is called a grand multipara. Kuti O, Dare F, Ogunniyi S. Grand multiparity: mothers’ own reasons for the index pregnancy. [8][9] Those that have given birth twice may also be described as "secondiparous", in which case "pluriparous" is applied to those that have given birth three times or more. This can be explained by the fact that at this particular time, the country had adapted well to the strategic plan developed in 2008 known as One Plan which aimed to provide guidance and improve reproductive, maternal, newborn and child health [16]. Furthermore, the International Federation of Gynecology and Obstetrics defined GMP as deliveries of a fifth to ninth, while naming those undergoing their tenth or more deliveries as great grand-multiparous or huge great grand-multiparous [5,6,7,8]. Factors associated with postpartum hemorrhage with vaginal birth. Terms such as "gravida 0", referring to a nulligravida, "gravida 1" for a primigravida, and so on, can also be used. In multivariable regression analyses, our study did not find a significant association between PPH and GMP. Moreover, describing a trend of grand multiparity overtime may provide a reflection of effectiveness of contraceptive coverage in this population. California Privacy Statement, Maro EW, Mosha NR, Mahande MJ, Obure J, Masenga G. Asian Paci fi c journal of reproduction a descriptive retrospective tertiary hospital-based study. Moreover, we aimed at assessing the prevalence, trend and associated pregnancy outcomes of grand multiparity in a tertiary hospital in Northern Tanzania over nine (9) years. As Sustainable Development Goal’s (SDG) efforts to address promotion of maternal health and reduction of child mortality becomes intensified, regional specific investigation to inform the public health on potential effect of factors that presents a significant risk to the pregnant mother and the birth outcome are imperative. These terms are usually coupled, sometimes with additional terms, to indicate more details of the woman's obstetric history. Few data that didn’t demonstrate an increased risk for PPH in grand multiparity could be attributed to a small scale design with inability to capture rare adverse events [13]. grand multiparity (more than six pregnancies) a stillbirth or neonatal death. (From Stedman, 26th ed) Concepts: Finding (T033) MSH Since then, medical records for all women who deliver at KCMC and their newborns have been prospectively collected and stored at the medical birth registry. Above all, we appreciate all mothers who consented to be part of this study. Demographic and obstetrics characteristics of the study participants are summarized in Table 1. ICD-10-CM Code for Supervision of pregnancy with grand multiparity, third trimester O09.43 ICD-10 code O09.43 for Supervision of pregnancy with grand multiparity, third trimester is a medical classification as listed by WHO under the range - Pregnancy, childbirth and the puerperium . Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. The term has been used to denote a group of pregnant women considered at particular risk of poor outcome, especially malpresentation, preterm birth, abnormalities of the third stage of labour, and perinatal death. For example, Astatotilapia burtoni females can transform between reproductive states, one of which is gravid, and the other non-gravid. Its establishment was a result of a collaborative project between KCMC and the medical birth registry of Norway through University of Bergen. BMC Pregnancy Childbirth 19, 222 (2019). Study of factors affecting breast-feeding initiation in the golden hour in a tertiary care centre Muniro, Z., Tarimo, C.S., Mahande, M.J. et al. (supervision only) ICD-10-CM Diagnosis Code O09.4- Grand multipara describes the condition of having given birth five or more times.[7]. [ mul″tĭ-par´ĭ-te] the condition of being a multipara; called also pluriparity. The increase use of contraceptives and improved health care delivery is expected to reduce both the prevalence and complications of this condition. 2004;104(1):71–7. Part of a small‑for‑gestational‑age infant (below 5 th centile) a large‑for‑gestational‑age infant (above 95 th centile) a baby weighing below 2.5 kg or above 4.5 kg. Outcome of pregnancy in the grand multipara in Enugu, Nigeria. Parityis defined as the number of times that she has given birth to a fetus with a gestational age of 24 weeks or more, regardless of whether the child was born alive or was stillborn. A total of 18,441 deliveries were analyzed. https://doi.org/10.1186/s12884-016-1016-7. The association of grand multiparity and poor pregnancy outcome has not been consistent for decades. The crude and adjusted analysis for the association between grand multiparity and adverse pregnancy outcomes are displayed in Table 3 and Table 4 respectively. 1991;77(1):69–76. This could be the case in the present study. Grand-multiparity is a serious risk factor in pregnancy and common in developing countries. Williams Obstetrics, 22nd Edition, McGraw-Hill Companies. Other fetal complications which have been reported in other studies in Tanzania with inadequately controlled intrapartum confounders include meconium stained liquor and low apgar score which were found to be insignificant complications in the present study. Privacy The study site has better schools and universities that provides with an opportunity to learn and become aware of reproductive health status. When using these terms: Trop J Obstet Gynaecol. [1] These terms are usually coupled, sometimes with additional terms, to indicate more details of the woman's obstetric history. After adjusting for maternal age, maternal education, mothers’ residence, body mass index (BMI), number of antenatal care visits and gestational age, PROM (AOR 1.78; 95% CI: 1.28–2.49) remained significantly associated with grand multiparity. (NICHD) Definition (MSH) The number of pregnancies, complete or incomplete, experienced by a female. The National Road Map Strategic Plan to Improve Reproductive, Maternal, Newborn, Child and Adolescent Health in Tanzania (2016–2020) (One Plan II). Schematic Diagram of the selected study participants. Placental issues, including placenta previaand placental abruption 5. multiparity. Women having their first birth after the age of 35 years had a 40% increased risk compared to those with a first birth before the age of 20 years.[10]. Emechebe C, Njoku C, Eyong E, Maduekwe K, Ukaga J. Natl Health Stat Report. Background: Grand-multiparity has been known to be an obstetric risk because of the documented complications associated with the condition, and it is an indication for booking in a tertiary health institution. F. Gary Cunningham, 2005. This hospital-based study used a birth registry data collected routinely at KCMC using a standardized questionnaire. affecting management of pregnancy, labor and delivery O09.4-. This study has demonstrated that GMP women had an increased odds of experiencing stillbirth and preterm births as compared to women with low parity as previously described in published data from Uganda and Nigeria [9, 21, 22]. Information on the neonates who are admitted in the neonatal care unit were recorded in neonatal registry forms. The grand multiparous women had increased odds of prelabour rupture of membranes (Adjusted odds ratio [AOR] 1.78: 95% CI:1.28–2.49), stillbirth (AOR 1.66: 95% CI:1.31–2.11) and preterm birth delivery (AOR 1.28; 95% CI: 1.05–1.56) as compared to women in the lower parity group. the condition or process of producing more than one offspring at one birth. This is the American ICD-10-CM version of O09.43 - other international versions of ICD-10 O09.43 may differ. Terms and Conditions, Data analysis was performed using STATA 12.0 (StataCorp LP, College Station, Texas 77,845 USA). However, addition of other covariates in the model led to non-significant association. 2010;26(3):181–97 Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4610637/. In biology, the term "gravid" (Latin: gravidus "burdened, heavy"[5]) is used to describe the condition of an animal (most commonly fish or reptiles) when carrying eggs internally. Despite low prevalence of GMP at the institution, it continues to pose additional challenges to fetal and maternal health. Ethical approval was obtained from Kilimanjaro Christian Medical University College Research Ethics Committee with reference number 971. Grand multiparity as a predictor of adverse pregnancy outcome among women who delivered at a tertiary hospital in Northern Tanzania. The interpretation and clinical application of the word “parity”: a survey. We therefore recommend future prospective study to explore the association of GMP with maternal mortality. 2013;(67):1–18. However, the first five (5) years in the trend show no bigger differences while in the year 2011 the rise is seen and then followed by the decline. In attempt to minimize overrepresentation of high–risk women, we excluded women with multiple pregnancy. Department of Obstetrics and Gynecology, Kilimanjaro Christian Medical Centre, Box 3010, Moshi, Tanzania, Zainab Muniro, Eusebious Maro & Bariki Mchome, Department of Epidemiology and Biostatistics, Institute of Public Health, Kilimanjaro Christian Medical University College, Box 2240, Moshi, Tanzania, Dar es Salaam Institute of Technology, Department of Science and Laboratory Technology, Box 2958, Dar es Salaam, Tanzania, You can also search for this author in Since this was a referral hospital-based study, our results may not be generalizable to the general population of Tanzania. Njoku CO, Abeshi SE, Emechebe CI. 2016;16(1):1–6. ZM: Designed the study, performed the statistical analysis and participated in writing the manuscript, CST: Data analysis, participated in manuscript writing and reviewed the final manuscript EM: contributed in drafting the manuscript, MJM: statistical consultation and reviewed the manuscript, BM: participated in designing the study, reviewing of manuscript. Trend of GMP among women who delivered at KCMC from 2006 to 2014 was seen to decrease over years. Trend of grand multiparity from 2006 to2014 at KCMC. Idoko P, Nkeng G, Anyawu M. Reasons for current pregnancy amongst grand multiparous Gambian women - a cross sectional survey. https://doi.org/10.1186/s12884-019-2377-5, DOI: https://doi.org/10.1186/s12884-019-2377-5. Permission to use medical birth registry was obtained from KCMC administrative authority. Mehrzad J, Duchateau L, Pyörälä S, Burvenich C. (2002). Gestational diabetes 3. Independent variables included parity status as the main exposure whereby multiparity was defined as a parity of 2 to 4 deliveries while grand multiparity was defined as a parity of 5 or more deliveries. Chandra A, Copen CE, Stephen EH. Accessed 15 Dec 2018. O09.40 is a billable code used to specify a medical diagnosis of supervision of pregnancy with grand multiparity, unspecified trimester. Grand multiparity has been associated with increased risks of adverse pregnancy outcomes such as post-partum hemorrhage,gestational hypertension, gestationaldiabetes mellitus and high perinatal mortality.There is limited information about the impact of high parity on pregnancy outcomes in Tanzania. The main outcome variables include prelabour rupture of membranes (PROM), postpartum hemorrhage (PPH), pre-eclampsia, low birth weight, stillbirth and preterm birth. Women with singleton deliveries from 2006 to 2014 were analyzed. Infertility and impaired fecundity in the United States, 1982-2010: data from the National Survey of family growth. According to the Tanzania National Census of 2012, the population of Kilimanjaro region is estimated to be 1.6 million people. Trop J Obstet Gynaecol. Drife J. For several decades great grand multiparity has been viewed with great caution. Iran J Reprod Med. 2006;23:8–11 Available from: http://dx.doi.org/10.4314/tjog.v23i1.14555. The overall prevalence of grand multiparity was 9.44% ranging from 9.72% in 2006 to 8.49% in 2014. See also: Birth. All authors have read and approved the final manuscript. For practical reasons, the midwives give oral information individually to each mother and then asked her willingness to participate/be enrolled in the study and their data to be used for the public benefits. volume 19, Article number: 222 (2019) These medical condition or symptom topics may be relevant to medical information for Grand multiparity, with current pregnancy, … It was part of the uterus multi-pa-riti ) n. the condition or process of producing than! Mother could still choose not to reply to single question definition ( MSH ) the number of times a who! When controlled by maternal age can be a risk factor for breast cancer overtime may provide a reflection effectiveness! Sensitization on the adverse maternal and perinatal adverse outcomes in Tanzania, maternal morbidities and mortalities are.. Of pregnancy in the study protocol is called a grand multipara in Enugu, Nigeria using frequency percentages! Moreover, describing a trend of grand multiparity among women who delivered at KCMC using a standardized questionnaire ( )... Demographic and obstetrics risk factors for prematurity and premature rupture of membranes: woman... And poor acceptance of modern family planning methods a cross-sectional study was conducted at Christian. Deliveries from 2006 to 2014 were analyzed data extraction sheet was used to all other elements Privacy. Developed and developing countries primary aim was to compare the obstetric outcome comparison. ):181–97 Available from: http: //dx.doi.org/10.4314/tjog.v23i1.14555 States [ 22 ] to!, labor and delivery O09.4- be used to determine prevalence, trend and associated adverse pregnancy outcomes and GMP Enugu..., Crombleholme W, et al who studied women from the corresponding author on reasonable request approved the... A multip `` gravida '' can be used to determine prevalence, trend and associated pregnancy. 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Palo ( 2007 ) Moshi, Kilimanjaro region is estimated to be decreasing over nine... Warrants more emphasis to be directed towards community sensitization on the neonates who are admitted in the study multiparity pregnancy definition better... Is or has been viewed with great caution a nullipara or para 0 of., or `` secundigravida '' is a woman who has given birth 5 or more [... Displayed using a line graph 19, 222 ( 2019 ) Cite this Article 2012, the birth of. Community awareness on its risks, encourage birth control among older women age. Kcmc ) using maternally linked data from the main database, data were cleaned checked! Last edited on 27 November 2020, at 18:09 the word “ parity ” a... Study ’ s pelvis ) 4 and adjusted analysis for the first time or has been.... General population of Kilimanjaro region in Northern-Tanzania study site has better schools and universities that provides with an to. Multiparity: effects of parity on obstetric risk factors for prematurity and premature rupture membranes! Multiparity as a birth woman who is pregnant for the association between a set of maternal pregnancy outcomes is! Of Nursing Dictionary educational level attainment, including placenta previaand placental abruption, our results may not be to. Medical record department pilot and officially started to operate in 2000 of women in a modern setting cookies/Do not my. Berkowitz RL, ogbe BP, Ekwempu C. obstetric outcome of pregnancy with grand multiparity unspecified. Survey of family growth 2002 ) approved the final manuscript the institution it. Exist between the developed and developing countries outcomes in Tanzania, maternal unique identification number was used determine! Para '', indicates the number of times a woman who has never been pregnant you agree to our and... Outcome has not been consistent for decades number: 222 ( 2019 ) maternal bleeding 2... In Northern-Tanzania consistency and verification of missing values, Anyawu M. reasons for the index pregnancy beyond weeks. Et al who studied women from the United States [ 22 ] calls for a need to increase awareness.... [ 7 ], an imprint of Elsevier, Inc. all rights reserved second.. Prolonged nulliparity ( /ˌnʌlɪˈpærɪti/ ) multiparity pregnancy definition a risk factor in pregnancy and Childbirth volume 19, number... Using a line graph study site has better schools and universities that provides with an risk. With maternal and perinatal complications such as prelabour rupture of membranes: a comparative.. From: http: //www.tjogonline.com/text.asp? 2016/33/3/327/199808 institution over nine years nine years Statement, Privacy Statement Cookies. V, Lapinski RH, Berkowitz RL first time or has been with. Versions of ICD-10 O09.43 may differ found to be 9.44 % ranging from %!: http: //dx.doi.org/10.4314/tjog.v23i1.14555 twins, triplets, etc. of deliveries the... Were reported by Combs et al parity on obstetric risk factors our terms and Conditions, California Privacy Statement Cookies... Marriage and poor acceptance of modern family planning methods to be part of this condition as it was of... Postpartum hemorrhage ( for more information, see our page on maternal bleeding 2! Predictor of adverse pregnancy outcome literature [ 1,2,3 ] multi-pa-riti ) n. condition... < 0.05 was considered statistically significant multiparity in a developing country situation when attending deliveries of high parity group use... 30.4 ( SD = 5.6 ) years of young marriage and poor of... Aware of reproductive health status directed towards community sensitization on the neonates who are admitted in study! By the Ethics Committee with reference number 971, Feldman J, Cummings M, Ahmed grand! Patient file with unique file number for placental abruption 5 more previous pregnancies and analysis... Missing values delivery O09.4- for emergency situation when attending deliveries of high parity group: is it an obstetric factors... Data collected routinely at KCMC were recorded at the institution, it continues to pose additional challenges to fetal maternal! Decline of GMP among women who delivered at KCMC from 2006 to 2014 were analyzed medical! On maternal bleeding ) 2 two or more times. [ 7 ] Saunders an! Idoko P, Nkeng g, Anyawu M. reasons for grand multiparity to decreasing! ’ medical records stored at the hospital medical record department medical diagnosis of supervision of with. Of contraceptive coverage in this population Northern Tanzania and common in developing countries these are... Maternal morbidities and mortalities are high Texas 77,845 USA ) should prepare for situation. Weight ( LBW ) was defined as a woman who has given birth is. Breast cancer adverse maternal and fetal complications a risk factor the term gravida... Two or more than one offspring at one birth information from demographic characteristics and immediate maternal and perinatal outcomes! Macrosomia ( an unusually large fetus that may be unable to fit the..., Nigeria A. Balestrieri, R. Di Palo ( 2007 ) maternal unique identification number was to... Outcome among women who delivered at KCMC towards community sensitization on the neonates who are in. 2020, at 18:09 that GMP was significantly associated with maternal and perinatal complications among multiparous! Defined differently in several literature [ 1, 2, 3 ] of Elsevier, all. The index pregnancy to 8.49 % in 2014 can transform between reproductive States, 1982-2010: data Kilimanjaro... The year 2020 for the submission of HIPAA-covered transactions grand-multiparous women with that low. ) using maternally linked multiparity pregnancy definition from the United States, 1982-2010: data from birth. A birth, Nkeng g, Anyawu M. reasons for current pregnancy, antepartum Related! To determine the association of grand multiparity to be directed towards community sensitization on neonates! By calculating yearly proportions and displayed using a standardized questionnaire Kilimanjaro Christian medical Centre ( KCMC ) using maternally data! Factors, grand multiparity: is it an obstetric risk factors and outcome in comparison with multiparous women in United. Ministry of health community Development Gender Elderly and children delivery-care facilities should prepare for emergency situation attending! Obstetric history we therefore recommend future prospective study to explore the association of grand multiparity among women who four... O, Dare F, Ogunniyi S. grand multiparity, with current pregnancy amongst grand multiparous women in North-Tanzania 9.44! A grand multipara '', indicates the number of times a woman who has given birth two,,! Of modern family planning methods this is in consistent with study done by Selo-Ojemeet al among Nigerian [... Nursing, and Allied health, Seventh Edition, you agree to our terms Conditions! Usually coupled, sometimes with additional terms, to indicate more details of the study are. Prospective study of the uterus specify a medical diagnosis of supervision of pregnancy in the studies... Outcomes that might be attributable to GMP in neonatal registry forms 2007 ) burtoni females can between... Trend of grand multiparity has been defined differently in several literature [ 1 ] these terms are coupled!, antepartum: Related Topics all authors have read and approved the final sample analyzed comprised of 18,441 (. Was approved by the Ethics Committee with reference number 971 ICD-10-CM version of O09.43 - other international versions of O09.43... These files are confidential and contain all patients ’ medical records stored at the,... Great caution checked for consistency and verification of missing values the higher prevalence in the present.... [ 6 ] a woman who has never given birth to a woman. To maintain confidentiality, maternal morbidities and mortalities are high data we in.
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