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Grand multiparity

Sara Ellis Simonsen, CNM, MSPH, PhD
Michael W Varner, MD
Section Editor
Charles J Lockwood, MD, MHCM
Deputy Editor
Vanessa A Barss, MD, FACOG


A 1934 study suggested that increasing parity increased the risk of pregnancy complications, and first introduced the term "grand multipara" [1]. The author concluded that grand multiparity was dangerous because, in his study, maternal mortality increased steadily from the 5th to the 10th pregnancy. This topic will discuss issues related to grand multiparity.


A reasonable definition of grand multiparity is ≥5 live births and stillbirths ≥20 weeks of gestation, with great grand multiparity defined as ≥10 live births and stillbirths ≥20 weeks of gestation [2]. However, other definitions are also used. (See 'Variability in the definition of parity' below.)

Pregnancy losses under 20 weeks of gestation are considered abortions. Abortions are not counted toward parity, but are counted toward gravidity (ie, the number of times a woman has been pregnant, including her current pregnancy).


In the United States in 2014, 2.8 percent of live births were the fifth child in the family, 1.7 percent were the sixth or seventh child, and 0.5 percent were the eighth child and over [3]. Africa has the highest rate of grand multiparity [4].


The relationship between obstetric complications and parity has been studied extensively, with inconsistent findings. In addition to the usual limitations of observational data, there are several reasons for the discordancy:

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Literature review current through: Nov 2017. | This topic last updated: Oct 11, 2017.
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