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Is Grand Multiparity an Independent Risk Factor for Blood Transfusion?

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Abstract

The relation between grand multiparity and poor pregnancy outcome, especially postpartum hemorrhage and blood transfusion, has displayed inconsistent findings. Some studies have identified an increased maternal and neonatal morbidity, but the more recent literature is less clear about the risks. The objective of the study is to determine the association of grand multiparity with postpartum blood transfusion. We conducted a retrospective cohort study in a single tertiary university–affiliated medical center between 2011 and 2019. All women were categorized into one of three groups based on the number of previous deliveries: (a) nulliparous (no previous delivery), (b) multiparous (1–4 previous deliveries), and (c) grand multiparous (≥ 5 previous deliveries). We compared the demographic, clinical, and pregnancy outcomes of the study groups. The primary outcome was the need for red blood cell transfusion during the index admission. During the study period, there were 87,343 deliveries in our center. Among the study population, 36,777 (42.1%) were nulliparous, 49,072 (56.1%) were multipara, and 1494 (1.7%) were grand multiparous. Overall, 1602 women (1.8%) were treated with RBC transfusion. Cesarean delivery, macrosomia, preterm delivery, multiple gestations, antenatal anemia, thrombocytopenia, intrauterine fetal death (IUFD), and prolonged second or third stage of labor were more prevalent among women who were treated with RBC transfusion. After controlling for potential confounders, including maternal age, preterm delivery, IUFD, mode of delivery, and antenatal thrombocytopenia, grand multiparity was found to be an independent protective factor for RBC transfusion (RR = 0.2 (0.007–0.56). After controlling for cofounders, grand multiparity alone is not associated with postpartum blood transfusion.

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Authors and Affiliations

  1. Lis Maternity Hospital, Sourasky Medical Center, Tel Aviv, Israel

    Emmanuel Attali, Daniel Gabbai, Lee Reicher, Yoav Baruch, Anat Lavie, Yariv Yogev & Ariel Many

  2. Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

    Emmanuel Attali, Daniel Gabbai, Lee Reicher, Yoav Baruch, Anat Lavie, Yariv Yogev & Ariel Many

  3. Department of Obstetrics and Gynecology, Lis Hospital for Women, Tel-Aviv Sourasky Medical Center, Weizman 6, Tel Aviv, Israel

    Emmanuel Attali

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  1. Emmanuel Attali
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  4. Yoav Baruch
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Correspondence to Emmanuel Attali.

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The trial was conducted in accordance with the Declaration of Helsinki (2000) for human studies (IRB number TLV-0284–08). The authors declare no competing interests.

This research was partially presented as a poster at SMFM 2022.

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This research was partially presented as a poster at SMFM 2022.

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Attali, E., Gabbai, D., Reicher, L. et al. Is Grand Multiparity an Independent Risk Factor for Blood Transfusion?. Reprod. Sci. 31, 1117–1121 (2024). https://doi.org/10.1007/s43032-023-01400-y

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  • DOI: https://doi.org/10.1007/s43032-023-01400-y

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