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Fetal and placental growth in young, primiparous and old, multiparous rats.

Fetal and placental weights and peripheral blood progestagen concentrations were examined on days 13, 16 and 22 of gestation in young (3-5 month) nulliparous and old (9-12 month) multiparous, albino Wistar rats. There was no difference in fetal weights at any stage examined whereas placental weights were significantly heavier in the old rats at days 16 (71%) and 22 (38%). Blood progesterone concentrations were similar in the two groups at days 16 and 22 although concentrations of the less biologically active progestagen, 20 alpha-dihydroprogesterone, were higher (61%) at day 16 in the old rats. The relative hypertrophy of the placentas in the old rats could not be explained by reduced litter size or progesterone concentrations: it may represent a compensatory effect in response to a less favorable uterine environment.

20-alpha-Dihydroprogesterone↗

Principles and pitfalls in the analysis of prenatal treatment effects in multiparous species.

Developmental studies often assess the effect of treatment of the pregnant mother on offspring. The use of multiparous species such as rats and mice in such studies creates a special set of design and analysis problems. These arise for two reasons. First, the availability of many offspring per litter tempts the experimenter to inflate sample size by treating scores from several pups per litter as independent observations. Second, large litter size seldom makes it practical to measure exposure effects in all offspring of an exposed dam. Such studies commonly involve two-stage sampling: Drawing a random sample of dams for treatment, then drawing a second sample of pups per dam for neurobehavioral measurements. In this article, such sampling was modeled by two different simulations. The first, a standard Monte-Carlo approach, sampled from random-normal distributions for litter mean and within-litter variability. The second simulation sampled without replacement from actual data on weight of all pups in a series of 39 nontreated rat litters. These mutually-supportive approaches demonstrate that litter effects, even over as few as three litters, are generally large and statistically meaningful. Consequently, statistical significance tests are sensitive to litter effects. Inflation of sample size by treating as few as 2 pups per litter as independent measurements can almost triple the nominal 0.05 alpha level. Furthermore, two-stage sampling increases the within-treatment error term and correspondingly reduces statistical power relative to one-stage sampling.(ABSTRACT TRUNCATED AT 250 WORDS)

Analysis of Variance↗

Differences between primiparous and multiparous dairy cows in the inter-relationships between metabolic traits, milk yield and body condition score in the periparturient period.

During the early postpartum period dairy cows mobilize fat and muscle to support lactation. This is associated with alterations in blood metabolite and hormone profiles which in turn influence milk yield and fertility. This study developed models to determine how metabolic traits, milk yield and body condition score were inter-related at different times in the periparturient period and to compare these relationships in primiparous (PP, n=188) and multiparous (MP, n=312) cows. Data from four previous studies which included information on blood metabolic parameters, parity, milk yield, body condition score and diet were collated into a single dataset. Coefficients of polynomial equations were calculated for each trait between -1 week pre-calving and week +7 postpartum using residual maximum likelihood modelling. The completed dataset was used in a multiple correlation model to determine how the best fit curves were related to each other over time. PP cows had higher concentrations of insulin-like growth factor-I and lower beta-hydroxybutyrate concentrations throughout, higher leptin concentrations pre-partum and both the peak in non-esterified fatty acids and the nadir in urea concentration occurred earlier after calving. These differences were associated with significantly lower milk production. Leptin concentrations fell at calving and were related to body condition score. Insulin was negatively correlated with yield in MP cows only. In MP cows the relationship between insulin-like growth factor-I and yield switched from negative to positive between weeks +4 and +7. Both beta-hydroxybutyrate and urea were positively related to yield in PP cows. In contrast, in MP cows beta-hydroxybutyrate was negatively correlated with yield and urea was strongly related to body condition score but not yield. These results suggest that there are differences in the control of tissue mobilization between PP and MP cows which may promote nutrient partitioning into growth as well as milk during the first lactation.

3-Hydroxybutyric Acid↗

Risk of poor pregnancy outcomes: is it higher among multiparous teenage mothers?

It is commonly believed that pregnancy outcomes for multiparous teenage mothers are worse than those for teenage women experiencing a first birth. This article, based on a review of the literature, finds that when teenage mothers having a second birth are compared with those having a first birth, the second births often have worse outcomes. However, when the first and second birth to the same mother are compared, teenagers follow the pattern of older women, i.e., the second births usually have better outcomes than the first. This difference is probably due to selection bias.

Adolescent↗

Incidence of ovarian cancer of grand multiparous women--a population-based study in Finland.

OBJECTIVES: Parity is known to induce protective effects on ovarian cancer. This study aimed to evaluate how far upon births the protection reaches, the effect of age at first birth, the interval between births in the whole population and the length of time from the first to the last birth and from the last birth to cancer among postmenopausal women. METHOD: The population-based cohort consisted of 87,929 grand multiparous (GM) women, i.e. women with at least 5 deliveries. Standardised incidence ratios (SIRs) were calculated by dividing the number of observed cancer cases by the expected number based on the national incidence rates, both extracted from the population-based Finnish Cancer Registry. Conditional logistic regression for the case-control design nested in the GM cohort was used to estimate proportional hazards by different factors. RESULTS: The SIR for ovarian cancer among GM women was low (418 cases; SIR 0.64, 95% confidence interval 0.58-0.69). Further births over five did not give additional protection. The relative risk did not vary significantly by age at first birth or interval between the births in any histological subtype. CONCLUSION: The risk of ovarian cancer was low in all GM women no matter how many children and at which ages they had delivered or contracted cancer.

Adult↗

Diminished maternal responsiveness during pregnancy in multiparous female common marmosets.

Common marmoset monkeys (Callithrix jacchus) live in small groups in which, usually, only a single female breeds and all group members provide infant care. When two females breed concurrently, however, they may commonly kill one another's infants, especially during the peripartum period. To investigate the mechanisms underlying infanticide by breeding females, we characterized responses of multiparous females to infants and determined circulating hormone levels in adult females during early pregnancy, late pregnancy, and the early postpartum period. Additionally, we compared the responses of postpartum females to their own infants and infants of other females (unfamiliar infants). Postpartum females were highly maternal toward both their own and unfamiliar infants, and showed no differences in their behavioral or hormonal responses to the two. During both early and late pregnancy, however, these females exhibited longer latencies to initially approach unfamiliar infants and spent less time carrying unfamiliar infants. Moreover, females spent less time carrying unfamiliar infants during late pregnancy than early pregnancy. Most late pregnant females never carried infants, and those that did rejected them quickly. Prolactin concentrations were higher and progesterone concentrations lower postpartum than in early or late pregnancy, while estradiol concentrations, the estradiol-to-progesterone ratio, and cortisol levels were higher during late pregnancy. Within reproductive conditions, however, maternal behaviors were not correlated with hormone levels. These results suggest that maternal responsiveness in marmosets may be attenuated during pregnancy, especially late pregnancy, and this may contribute to infanticide by breeding females.

Aggression↗

Abdominoplasty in multiparous women with severe musculoaponeurotic laxity.

The results and complications of abdominoplasty in 20 consecutive multiparous women with very severe musculoaponeurotic laxity are presented. All patients presented with an abdomen that resembled a full-term pregnancy when the patient was in the erect posture. This very severe laxity was the end result of repeated pregnancies. All patients underwent a standard abdominoplasty with wide longitudinal plication using size 1 prolene sutures. Follow-up averaged 1 year. None of the patients had a major complication. However, all the patients had recurrence of the musculoaponeurotic laxity. Causes and classification of this recurrent laxity are discussed along with possible solutions.

Abdominal Muscles↗

Hepatic levels of cadmium, zinc and copper in multiparous, nulliparous and ovariectomized mice fed either a nutrient-sufficient or -deficient diet containing cadmium.

As a simulation of etiological factors known for Itai-Itai disease, female mice were subjected to the individual and combined stresses of dietary cadmium, nutrient-deficient diet, multiparity and ovariectomy. From age 68 days, female mice were maintained on either nutrient-sufficient (+) or -deficient (-), purified diets containing either 0.25 (environmental), 5, or 50 ppm Cd as CdCl(2); the nutritional composition of (-) diet simulated that of food consumed by Japanese women who contracted Itai-Itai disease. At age 70 days, half of the mice began a breeding regimen of six consecutive, 42-day rounds of pregnancy/lactation (PL mice); the remainder were maintained as virgin, non-pregnant controls (NP mice). Limited numbers of PL and NP mice were sacrificed at the end of each reproductive round. PL(+) mice taken in a given round had successively borne litters in that round and all preceding ones. PL(-) females taken at the end of round (R)-1, -2 and -3 had successively borne litters through those rounds; those taken at the end of R-5 or -6 had nonsuccessively borne litters in four of five or three of six rounds, respectively. At the end of the 252-day reproductive period, remaining females entered the 392-day, post-reproductive phase of the experiment. At age 546 days (mid-R-12), PL females having successfully borne at least three litters were ovariectomized (OV) to mimic human menopause, while NP females were either ovariectomized or sham-operated (SO). After surgery, all females were maintained to age 714 days (mid-R-16), then sacrificed. Food consumption, monitored on a weekly basis over the first nine rounds, was in general not significantly affected by dietary Cd level or nutrient deficiencies for females of the same reproductive status; consumption was increased about 2.5-fold in PL versus NP groups during the reproductive period and about 1.4-fold during the post-reproductive period. Over the reproductive period, small increases in liver concentrations of Zn and Cu were observed (ca. 3.1- and 2.5-fold, respectively) with far larger increases for Cd (ca. 22200-fold). Threshold hepatic Cd concentrations below which the concentrations of Zn and Cu were relatively constant and independent of Cd concentration were identified; they were 2.7 microg Cd/g liver for Zn and 3.3 microg Cd/g liver for Cu for females consuming (+) diet, and 4.9 microg Cd/g liver for Zn and 4.5 microg Cd/g liver for Cu for females consuming (-) diet. Regardless of Cd exposure level, round-by-round hepatic concentrations of Cd were generally 2- to 6-fold higher in PL than NP mice, while Zn or Cu levels were generally only 1.1- to 2.5-fold higher. For each reproductive round, hepatic concentrations of Cd in NP females were consistently about 10-fold greater in mice exposed to 50 than 5 ppm dietary Cd: corresponding Zn levels were essentially equivalent. For PL females. Cd levels were about 7-fold greater in 50 than 5 ppm Cd-exposed groups, however Zn concentrations were about 45% decreased. The pattern of Cd, Zn and Cu sequestration established during the reproductive period clearly differed from that of the post-reproductive period. Between R-6 and -16, hepatic concentrations of Cd, Zn and Cu appreciably decreased (14-69%) in 5 ppm Cd-exposed NPOV and PLOV females regardless of diet-type consumed. At the 50 ppm Cd level, Cd and Zn concencentrations dramatically rose with increases in Cd (37-129%) exceeding those of Zn (12-21%).

Animals↗

Kidney changes in multiparous, nulliparous and ovariectomized mice fed either a nutrient-sufficient or -deficient diet containing cadmium.

As a simulation of the etiological factors known for Itai-Itai disease, a syndrome characterized by renal dysfunction and osteomalacia in its Japanese victims, female mice were subjected to the individual and combined stresses of dietary Cd, nutrient-deficient diet, multiparity and ovariectomy. Renal function as affected by the etiological factors was periodically evaluated by determination of protein, amino acid, glucose and Cd concentrations in urine; periodic changes in skeletal Ca status were assessed relative to current renal function. Renal metabolism of Cd, Zn and Cu was also examined. At age 68 days, female mice were given nutrient-sufficient (+) or -deficient (-), purified diets containing either 0.25 (environmental), 5, or 50 ppm Cd as CdCl(2); the nutritional composition of (-) diet simulated that of food consumed by Japanese victims of Itai-Itai disease. At age 70 days, half of the females began a breeding regimen of six consecutive, 42-day rounds of pregnancy/lactation (PL mice); the remainder were maintained as virgin, non-pregnant controls (NP mice). Limited numbers of PL and NP mice were sacrificed at the end of each reproductive round. PL( + ) mice taken in a given round had successively borne litters in that round and all preceding ones. PL(-) females taken at the end of round (R)-1, -2 and -3 had successively borne litters through those rounds; those taken at the end of R-5 or R-6 had nonsuccessively borne litters in four of five or three of six rounds, respectively. At the conclusion of the 252-day reproductive period, remaining females entered the 392-day, post-reproductive phase of the experiment. At age 546 days (mid-R-12), PL females having successfully borne at least three litters were ovariectomized (OV) to mimic human menopause; at the same time, NP females were either ovariectomized or sham-operated (SO). After surgery, all females were maintained to age 714 days (mid-R-16), then sacrificed. Spot urine samples were taken from individual mice at the end of most reproductive rounds (R-2-->6), prior to surgery (mid-R-10), and prior to final sacrifice (late-R-15); samples were also collected via metabolism cages at the end of R-10. Food consumption, monitored on a weekly basis over the first nine rounds, was generally not significantly affected by dietary Cd level or nutrient deficiencies in females of the same reproductive status; consumption was increased about 2.5-fold in PL versus NP groups during the reproductive period and about 1.4-fold during the post-reproductive period. At each of the three dietary Cd levels and after all reproductive rounds, mean renal Cd concentrations were 1.2- to 5.6-fold higher in PL than NP mice. After six reproductive rounds, renal Cd concentrations in PL(+) and (-) groups exposed to 50 ppm Cd had reached 155 and 179 microg Cd/g kidney, respectively. Although these levels fell within a concentration range (145-200 microg Cd/g) where cadmium-induced renal dysfunction could be anticipated, no significant, Cd-dependent changes in mean urinary amino acid or protein concentrations were found. Moreover, among the same population, a 12% incidence of elevated urinary Cd (> or = 250 ng/ml) was noted, however none of the affected individuals exhibited depressed total calcium content (TCa) or calcium:dry weight ratios (Ca:DW) for femur. Such results suggested that the Cd-induced, skeletal demineralization observed in mice during the reproductive period (Bhattacharyya et al., Toxicology 1988a; 50: 193-204; Whelton et al., Toxicology 1994: 91: 235-251) likely occurred in the general absence of cadmium-induced renal dysfunction. By the end of the post-reproductive period, the incidence of elevated urinary Cd increased to 26% among ovariectomized females: of these, 89% with urinary Cd > or = 345 ng/ml exhibited decreases in TCa and/or Ca:DW values for femur or lumbar vertebrae that exceeded one S.D. of their group mean. Such results suggested that skeletal demineralization observed at

Amino Acids↗

Uterine rupture in second trimester abortion in a grand multiparous woman. A complication of misoprostol and oxytocin.

Rupture of unscarred uterus during the second trimester is rare. There have been only 32 cases reported in the literature since 1968. A case of ruptured uterus in a grand multiparous woman is presented. To our knowledge, this might be the first reported case in the English literature of uterine rupture during second trimester termination of pregnancy using a prostaglandin E1 analogue (Misoprostol) and oxytocin.

Abdominal Pain↗

The outcome of grand-multiparous pregnancies of Arabic and Jewish populations in peripheral and central areas of Israel.

OBJECTIVE: To compare the antepartum and intrapartum course of Jewish and Arab great-grandmultiparas from central and peripheral areas in Israel to age-matched control multiparous women. METHODS: Medical records of four groups of parturients were compared: great-grandmultiparas (para > or = 9) and multiparae (para 2-5) delivering at Nazareth E.M.M.S. hospital (mostly Arabs) and Hadassah-Ein-Kerem hospital in Jerusalem (mostly Jews). The control groups consisted of demographically and geographically matched multiparas. Data was collected on prenatal care received, antepartum complications, as well as the intrapartum complications traditionally associated with high parity (e.g. malpresentation, placental abnormalities, peripartum hemorrhage, shoulder dystocia). Neonatal records were also examined to determine any neonatal morbidity or mortality. RESULTS: There were 139 and 141 great-grandmultiparas in the Nazareth and the Jerusalem study groups, respectively (mean parity was 10.1 and 10.9, respectively), and 142 and 139 multiparas in the Nazareth and the Jerusalem control groups, respectively (mean parity was 2.9 and 2.5, respectively). The rate of physician visits during the prenatal period in the Nazareth and the Jerusalem study groups was 2.3 +/- 2.4 and 3.2 +/- 2.7, respectively (p=0.0041). This rate was significantly higher in the controls of both areas (4.0 +/- 3.0 and 4.9 +/- 2.9, respectively). There was no difference in the rate of nurse visits in all groups in all areas. Maternal and neonatal outcomes were similar in both study groups, and were also similar in the control groups, but perinatal mortality was higher in both great-grandmultiparous groups compared to the controls (11/280 and 2/281, respectively; p<0.05). CONCLUSIONS: The differences in the intensity of prenatal care between these rural and urban areas did not affect the maternal outcomes of great-grandmultiparous pregnancies. In addition, there were no significant differences in maternal outcomes between great-grandmultiparas and multiparas in rural and urban areas although prenatal care was less intense in the former. However, increased incidence of perinatal mortality in the great-grandmultiparas may be due to factors unrelated to prenatal care intensity or quality.

Adult↗

Reproductive performance of multiparous rabbit lactating does: effect of lighting programs and PMSG use.

This study aims to determine if Pregnant Mare Serum Gonadotrophin (PMSG), used for oestrous synchronization in multiparous lactating does, could be replaced by one of the following lighting schedules without impairing reproductive performance: (a) 12-h L (light)/12-h D (dark) or (b) 8-h L/16-h D, until day 6 before artificial insemination (AI), when in both cases photoperiod was changed to 16-h L/8-h D and maintained until the day of AI, and in the following 4 days post Al the light hours were progressively reduced to the initial schedules. Two groups of 20 does each were respectively submitted to one of the lighting schedules specified above. All does were artificially inseminated in 6 consecutive cycles at 42 days intervals. In the first, third and fifth AIs, PMSG (20 IU/doe via sc 48 h before AI) was used in the two groups of does, whereas in the second, fourth and sixth Als no hormonal treatment was used. Degree of oestrous synchronization (also referred in text as sexual receptivity) was estimated by the colour of the vulva at AI. Reproductive performance of does was evaluated based on fertility (kindling rates), prolificity, mortality at birth, mortality at 21 days post birth, weight of the litter at 21 days post birth and number of weaned rabbits. Oestrous was better synchronized when PMSG was used with any of the two lighting programs. Without using PMSG, a photoperiod of 12-h L/12-h D until 6 days before AI resulted in a better sexual receptivity of does than 8-h L/16-h D. Fertility, prolificity, mortality of young rabbits at 21 days, the weight of the litters at 21 days and the number of weaned rabbits did not vary with the lighting program and were not affected by the PMSG treatment. Mortality at birth, however, was higher (+1 dead kit per litter) in litters housed under a light program of 12-h L/12-h D. Global productivity (number of weaned rabbits per 100 inseminated does) was better when using PMSG, for both lighting schedules. When using a photoperiod of 12-h L/12-h D until 6 days before AI, and omitting the PMSG treatment, global productivity was scarcely reduced, however, it was considerably impaired when using a photoperiod of 8-h L/16-h D until 6 days before AI and no PMSG treatment.

Animals↗

Hormones, IgG and lactose changes around parturition in plasma, and colostrum or saliva of multiparous sows.

Blood, colostrum and saliva samples were serially taken from 6 multiparous sows from day 109 of gestation until day 3 postpartum. Plasma was assayed for oestradiol-17beta (E2), progesterone (P4), prolactin (PRL), cortisol, immunoglobulin G (IgG) and lactose. Colostrum was assayed for E2, P4, IgG and lactose. Lactoserum, obtained after ultra centrifugation of colostrum, was assayed for PRL. Saliva was assayed for cortisol. Time-related variations in hormone, IgG and lactose concentrations measured in plasma were parallel to those measured in colostrum, lactoserum or saliva. However, the concentrations were higher in colostrum or lactoserum and lower in saliva than in plasma. Ratios of concentrations of cortisol in saliva and PRL in lactoserum over those in plasma did not vary with time and averaged 0.2 and 1.6, respectively. Conversely, the ratios of concentrations of E2 and P4 in colostrum over those in plasma varied with time (P < 0.05) but were quite constant before the end of parturition, averaging 2.7 and 3.6, respectively. The ratios of concentrations of IgG and lactose in colostrum over those in plasma also varied with time (P < 0.05). The concentrations of hormones in plasma on the one hand and in colostrum, lactoserum or saliva on the other hand were significantly correlated but correlations varied with time (PRL across periods: r = 0.31; cortisol across periods: r = 0.60; E2 during parturition: r = 0.83; P4 before parturition: r = 0.82; P4 during parturition: r = 0.67). The present results indicate that around parturition, assays of hormones in colostrum or saliva can be used to study the hormonal status of sows. Furthermore, variations in colostrum and plasma concentrations of IgG and lactose are good indicators of the transition from colostrum to milk synthesis.

Animals↗

Bone mineral density in grand multiparous women with extended lactation.

OBJECTIVE: We sought to assess whether the accumulation of multiple, frequent pregnancies and the accompanying repeated extended lactation events was a risk factor for low bone mineral density and osteoporosis. STUDY DESIGN: The study population consisted of 30 grand multiparous women who had borne at least 6 children and lactated for at least 6 months with each child, as well as 6 nulliparous, premenopausal women from a population of Finnish American women associated with the Laestadian Church in Washington State. The Church membership has not embraced contraception or extensive bottle-feeding, resulting in a group of women who are either pregnant or lactating during most of their adult reproductive lives. The medical history included the delivery date, birth outcome, infant birth weight, and number of months lactated for each pregnancy, as well as other health information. Bone mineral density of the lumbar spine, femoral neck, and radius was measured with the Hologic QDR 4500-C dual-energy x-ray absorptiometry scanner. Proc Genmod, SAS version 6.14 (Statistical Analysis Systems, Inc, Cary, NC), was used to perform a Wilcoxon test for a nonparametric analysis of covariance and significance adjusted for age and body size. RESULTS: The 2 study groups did not differ in terms of body mass index, history of smoking, or family history of osteoporosis and fracture, although the parous group was, on average, 8 years older than the nulliparous group (P <.05). The accumulation of repeated pregnancy and lactation events without a recovery interval was not associated with lowered bone mineral density or the presence of osteoporosis or osteopenia. CONCLUSIONS: This study suggests that bone mineral density levels can be sustained in the presence of the rapidly changing hormone environment associated with multiple pregnancies accompanying lactation events without a "recovery" interval.

Adult↗

Health insurance status and mood during pregnancy and following birth: a longitudinal study of multiparous women.

OBJECTIVE: The objective of this study was to investigate the relationship between health insurance status and mood during pregnancy and following childbirth. METHOD: 320 women were recruited in the early stage of pregnancy to participate in a longitudinal, prospective study of the psychological aspects of childbirth among multiparous women. Study volunteers were surveyed during each trimester of pregnancy and 2 and 8 months following childbirth. A range of self-administered psychometric tests were used to assess mood (Profile of Mood State), locus of control, defence style and partner support. Demographic information including health insurance status was noted at study entry. RESULTS: Public patients consistently had a more disturbed mood compared with private patients. This difference reached statistical significance during the second and third trimesters of pregnancy and 8 months after birth. Multivariate analysis was undertaken to identify predictors of mood during pregnancy and following birth. A better mood score was positively associated with private health insurance, a more caring partner and mature defence style, and negatively associated with external locus of control and immature defence style. A distinct mood pattern during pregnancy and following childbirth was observed and is described. CONCLUSIONS: Public patients have a more disturbed mood during pregnancy and following childbirth compared with private patients. This information is relevant when planning social, psychological and psychiatric services that target childbearing women.

Adult↗

Male to female ratio in newborns of grand grand multiparous women.

The male to female ratio in newborns of grand grand multiparous women was evaluated in 569 Jewish Orthodox women and 28 Muslim women. A total of 882 babies was born on the > or = 10th delivery; 460 (52.2%) were males and 422 (47.8%) were females (sex ratio = 1.06). Newborn sex ratio did not significantly change with respect to birth order or maternal age. It is suggested that parity and increasing maternal age do not affect the sex ratio of newborns and that ethnic and environmental variables may play a role in the deviations in offspring sex ratio observed among different populations.

Adult↗

Comparative survival of lethally irradiated inbred male mice inoculated with marrow from virgin or multiparous female donors.

The response of marrow from virgin female donors to the antigens controlled by the Y chromosome of syngeneic male recipients varied with different strains of mice and was independent of their H-2 genotype. Marrow from syngeneic multiparous donors might produce a greater response to male antigens than that observed with marrow from virgin females. The sensitization of the mother to her male progeny indicated that these antigens were expressed before parturition. The reduced responsiveness of mothers to some alloantigens and the accompanying increased responsiveness to male antigens suggested a difference in the time during embryonic development when these antigens were expressed.

Animals↗

Effect of grand multiparity on intrapartum and newborn complications in young women.

OBJECTIVE: To examine the effect of high parity on complications in young women, aged 18-34 years. METHODS: Seven years of Utah birth certificate data were reviewed (1995-2001). Young nulliparas and primiparas were compared with young grand and great grand multi-paras by using logistic regression. Young grand multiparas were compared with older grand multiparas. RESULTS: Young grand multiparas were more likely to have a preterm delivery and less likely to experience fetal distress, instrumented delivery, cesarean delivery, and any intrapartum complication than young nulliparas or primiparas. Young grand multiparas were less likely to experience many complications than their older counterparts. CONCLUSION: Among young women, grand and great grand multiparity does not increase the risk for most intrapartum and newborn complications. Young grand and great grand multiparas are at significantly decreased risk for many complications when compared with young women of lower parity and older grand and great grand multiparas. LEVEL OF EVIDENCE: II-2.

Adult↗