Maternal Risks In Antenatal, Intranatal, Postnatal And Its Impact On Pregnancy Outcomes In Grand-Multiparous Women

Abstract

Objective: Identify maternal risks during antenatal, intranatal, and postnatal among grandmultiparous women and its effects on pregnancy outcome, and their relation with some variables. Methodology: A descriptive, cross sectional , purposive study was carried on (200) laboring women which consist two groups 100 multiparous women had (Para2-4) and 100 grandmultiparous women had (Para ≥ 5) , who were admitted in three hospitals (Baghdad Teaching Hospital, Al- Yarmook Teaching Hospital, Fatima Al- Zahra’a Maternity and Pediatric Teaching Hospital), during the period from 29 April to 8 August 2010. The data was collected through interview technique and use constructed questionnaire format which consists four parts, first part sociodemographic characteristics, second part reproductive history, third part maternal health problems during the current pregnancy, delivery, and postpartum, and review patient records.Validity and Reliability of the questionnaire were determined through panel of experts and pilot study, data were analyzed through the application of descriptive statistical analysis (percentage, frequencies, mean and standard deviation) and inferential statistical analysis (Chi-square test, Fisher’s test, Correlation coefficient), and all the statistical procedures were tested at P ≤0.05.Results: The results revealed that the incidence of antenatal, intranatal and postnatal complications were significantly more among grandmultipara who had (para≥5) compared to multipara who had (para 2-4)(P≤0.05), these complications were: anaemia, pregnancy induced hypertension, ante partum haemorrhage, stress urine incontinence, mal presentation, macrosomia, and uterus prolapse. Health status of the majority of neonates for both groups (85%, 82%) were good, their apgar score was (7-10) in five minute of neonate's life, and most of them did not have congenital anomalies, only 3% in each group had neonate death after delivery.There is a significant relationship in age for both groups and antenatal complications, while there is significant relationship in age of multipara(2-4) and intranatal complications, and there are significant relationship in occupation and prenatal care visit and postnatal complications among grandmultipara . Conclusion: Incidence of antenatal, intranatal, and postnatal complications is significantly higher in grandmultiparity compared with multiparity.Recommendations: The importance of health awareness for mother concerning complications associated with antenatal, intranatal, and postnatal which are increased for subsequence and high pregnancies through educational programs and mass media, and emphasize on nursing role in this field. Improvement and promotion of prenatal health services especially for those women with high risk.