EHJMED Logo
Back to Issue
COMPARISON OF LABOUR PATTERN AND OUTCOMES AMONG MULTIPAROUS AND GRANDMULTIPAROUS WOMEN AT A TERTIARY HEALTH FACILITY IN OWERRI, IMO STATE, NIGERIA
Category: Original Articles
Published: October 2026
Issue: Vol. 4, Issue 2
Pages: 271 - 279
Authors
Bartholomew Okorochukwu
Federal Teaching Hospital Owerri
barthychuks@gmail.com
Ojukwu Ogbonna
Federal Teaching Hospital Owerri
ojukwuogbonna@gmail.com
Chiemeka Onumajuru
Federal Teaching Hospital Owerri
Abstract

Background: Grandmultiparity remains prevalent in many low- and middle-income countries and has traditionally been associated with adverse maternal and perinatal outcomes. However, whether these adverse outcomes are attributable to parity itself or to confounding maternal characteristics remains controversial. Contemporary evidence from southeastern Nigeria is also limited.
Objective: To compare labour patterns and maternal and perinatal outcomes between grandmultiparous and frequency matched multiparous women delivering at a tertiary health facility in southeastern Nigeria.
Methods: This retrospective comparative study included 458 women (229 grandmultiparous [parity ≥5] and 229 frequency matched multiparous [parity 2–4]) who delivered between January 2016 and December 2018. Participants were matched for maternal age, gestational age, booking status, and socioeconomic class. Data were extracted from hospital records and analysed using SPSS version 20. Categorical variables were compared using Chi-square or Fisher's exact test, with P<0.05 considered statistically significant.
Results: Grandmultiparous women had significantly higher rates of spontaneous labour (87.8% vs. 60.3%), caesarean delivery (23.6% vs. 11.4%), postpartum haemorrhage (17.5% vs. 7.9%), postpartum collapse (3.1% vs. 0.4%), and perinatal mortality (5.2% vs. 0%) (all P<0.05). Multiparous women were more likely to require labour augmentation, induction or stimulation, prolonged second-stage labour, and instrumental vaginal delivery (all P<0.05). No significant differences were observed in first-stage labour duration, retained placenta, intrapartum fever, birth weight, perinatal asphyxia, or neonatal admission.
Conclusion: Despite matching for major maternal characteristics, grandmultiparity remained associated with increased risks of caesarean delivery, postpartum haemorrhage, postpartum collapse, and perinatal mortality. Grandmultiparous women should continue to receive specialist antenatal care and delivery in facilities capable of providing comprehensive emergency obstetric and newborn care.

Keywords:
Caesarean section; Grandmultiparity, Labour; Maternal outcome, Perinatal mortality, Postpartum haemorrhage
References
  1. World Health Organization. Trends in maternal mortality 2000 to 2020: estimates by WHO, UNICEF, UNFPA, World Bank Group and UNDESA Population Division. Geneva: World Health Organization; 2023.
  2. United Nations Population Fund. State of World Population 2023: 8 Billion Lives, Infinite Possibilities. New York: UNFPA; 2023.
  3. Adeniran AS, Fawole AA, Fakeye OO, Ijaiya MA, Adesina KT. Grandmultiparity: evaluating obstetric and neonatal outcomes after eliminating confounders. Niger Postgrad Med J. 2014;21(1):34-39.
  4. Mgaya AH, Massawe SN, Kidanto HL, Mgaya HN. Grandmultiparity: is it still a risk in pregnancy? BMC Pregnancy Childbirth. 2013;13:241.
  5. Abasiattai AM, Umoiyoho AJ, Utuk NM, Inyang-Etoh EC, Asuquo OP. Grandmultiparity: outcome of delivery in a tertiary hospital in southern Nigeria. Niger J Clin Pract. 2011;14(3):345-348.
  6. Akwuruoha EO, Ideyi SC, Eleje GU, Udegbunam OI. Grandmultiparity and pregnancy outcome in Aba, Nigeria: a case-control study. Arch Gynecol Obstet. 2010;281(2):167-172.
  7. Abu-Heija AT, Chalabi HE. Great-grandmultiparity: is it a risk? J Obstet Gynaecol. 1998;18(1):36-40.
  8. Aliyu MH, Jolly PE, Ehiri JE, Salihu HM. High parity and adverse birth outcomes: exploring the maze. Birth. 2005;32(1):45-59.
  9. Roman H, Robillard PY, Verspyck E, Hulsey TC, Marpeau L, Barau G, et al. Obstetric and neonatal outcomes in grandmultiparity. Obstet Gynecol. 2004;103(6):1294-1299.
  10. Alsammani MA, Ahmed SR. Grandmultiparity: risk factors and outcome in a tertiary hospital: a comparative study. Mater Sociomed. 2015;27(4):244-248.
  11. National Population Commission (Nigeria), ICF. Nigeria Demographic and Health Survey 2018. Abuja, Nigeria, and Rockville, MD: National Population Commission and ICF; 2019.
  12. World Bank. World Development Indicators: Fertility rate, total (births per woman) — Nigeria. Washington (DC): World Bank; 2024.
  13. Eze JN, Okaro JM, Okafor MH. Outcome of pregnancy in grandmultipara in Enugu, Nigeria. Trop J Obstet Gynaecol. 2006;23(1):8-11.
  14. Ogbe AE, Ogbe BP, Ekwempu CC. Obstetric outcome of pregnancy in grandmultiparous women at Jos University Teaching Hospital. Jos J Med. 2010;6:1-5.
  15. Ogedengbe OK, Ogunmokun AA. Grandmultiparity in Lagos, Nigeria. Nig Med Pract. 2001;39:11-14.
  16. Ojenuwah SAO. Obstetric outcome in grandmultipara in Bida, North Central Nigeria. Trop J Obstet Gynaecol. 2006;23:27-29.
  17. Hoque M, Hoque E, Kader SB. Pregnancy complications of grandmultiparity at a rural setting in South Africa. Iran J Reprod Med. 2008;6(1):25-31.
  18. Noraihan MN, Nor Azlin MI, Rohana S, Sulaiman S, Shafiee MN. Is grandmultiparity a significant risk in the new millennium? Malays J Med Sci. 2006;13(4):52-60.
  19. Tuladhar H, Dhakal N. Impact of antenatal care on maternal and perinatal outcome: a study at Nepal Medical College Teaching Hospital. Nep J Obstet Gynaecol. 2011;6(2):37-43.
  20. World Health Organization. WHO recommendations: intrapartum care for a positive childbirth experience. Geneva: World Health Organization; 2018.
  21. World Health Organization. WHO recommendations for the prevention and treatment of postpartum haemorrhage. Geneva: World Health Organization; 2012.
  22. Oyedeji GA. Socioeconomic and cultural background of hospitalized children in Ilesa. Nig J Paediatr. 1985;12(4):111-117.
View Full Article (PDF) Download PDF
How to Cite This Article
Bartholomew Okorochukwu, Ojukwu Ogbonna, Chiemeka Onumajuru. (October 2026). COMPARISON OF LABOUR PATTERN AND OUTCOMES AMONG MULTIPAROUS AND GRANDMULTIPAROUS WOMEN AT A TERTIARY HEALTH FACILITY IN OWERRI, IMO STATE, NIGERIA. Eastern Heartland Journal of Medicine, Volume 4, Issue 2, pp. 271-279.
Article Information

Submitted: March 23, 2026

Published: October 17, 2026

Pages: 271 - 279

Journal: Eastern Heartland Journal of Medicine

Publisher: Federal Teaching Hospital Owerri, Nigeria

ISSN: 2734-2875 (Print)