HIGH PARITY AS A RISK FACTOR FOR OBSTETRIC AND PERINATAL COMPLICATIONS: CURRENT STATE OF THE PROBLEM (LITERATURE REVIEW)
DOI:
https://doi.org/10.32782/3083-7324/2026.3.2Keywords:
grand multiparity, pregnancy outcomes, maternal outcomes, perinatal outcomes, obstetric complications, postpartum hemorrhageAbstract
Grand multiparity (GMP), commonly defined as having five or more deliveries beyond the threshold of fetal viability, continues to attract considerable attention due to its potential impact on pregnancy outcomes. Despite declining fertility rates in many countries and significant improvements in obstetric care, grand multiparity remains an important issue in modern obstetrics. The aim of this review was to summarize current evidence regarding the course of pregnancy, childbirth, and the postpartum period in women with grand multiparity, as well as to assess its role in the development of maternal and perinatal complications. A review of scientific publications, systematic reviews, meta-analyses, and international clinical guidelines published predominantly over the last decade was conducted. The available evidence indicates that grand multiparity may be associated with an increased incidence of maternal anemia, gestational diabetes mellitus, preterm birth, placental disorders, fetal macrosomia, postpartum hemorrhage, and adverse perinatal outcomes. However, most contemporary studies suggest that unfavorable pregnancy outcomes are not determined solely by the number of previous births. Maternal age, body mass index, interpregnancy interval, coexisting medical conditions, and obstetric history also play a substantial role. Particular attention has been drawn to the longterm consequences of multiple vaginal deliveries, including an increased risk of pelvic floor dysfunction. Therefore, grand multiparity should be considered an important component of comprehensive obstetric risk assessment. Management of these women requires an individualized approach during preconception counseling, antenatal care, delivery, and postpartum follow-up.
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