{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T23:06:10Z","timestamp":1791327970704,"version":"4.3.1"},"reference-count":25,"publisher":"Georg Thieme Verlag KG","issue":"07","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:p>\n            Objective\u2003Evidence is inconsistent regarding grand multiparity and its association with adverse obstetric outcomes. Few large American cohorts of grand multiparas have been studied. We assessed if increasing parity among grand multiparas is associated with increased odds of adverse perinatal outcomes.<\/jats:p><jats:p>\n            Study Design\u2003Multicenter retrospective cohort of patients with parity \u2265 5 who delivered a singleton gestation in New York City from 2011 to 2019. Outcomes included postpartum hemorrhage, preterm delivery, hypertensive disorders of pregnancy, shoulder dystocia, birth weight\u2009&gt;\u20094,000 and &lt;2,500\u2009g, and neonatal intensive care unit (NICU) admission. Parity was analyzed continuously, and multivariate analysis determined if increasing parity and other obstetric variables were associated with each adverse outcome.<\/jats:p><jats:p>\n            Results\u2003There were 2,496 patients who met inclusion criteria. Increasing parity among grand multiparas was not associated with any of the prespecified adverse outcomes. Odds of postpartum hemorrhage increased with history (adjusted odds ratio [aOR]: 2.65, 95% confidence interval [1.83, 3.84]) and current cesarean delivery (aOR: 4.59 [3.40, 6.18]). Preterm delivery was associated with history (aOR: 12.36 [8.70\u201317.58]) and non-White race (aOR: 1.90 [1.27, 2.84]). Odds of shoulder dystocia increased with history (aOR: 5.89 [3.22, 10.79]) and birth weight\u2009&gt;\u20094,000\u2009g (aOR: 9.94 [6.32, 15.65]). Birth weight\u2009&gt;\u20094,000\u2009g was associated with maternal obesity (aOR: 2.92 [2.22, 3.84]). Birth weight\u2009&lt;\u20092,500\u2009g was associated with advanced maternal age (aOR: 1.69 [1.15, 2.48]), chronic hypertension (aOR: 2.45 [1.32, 4.53]), and non-White race (aOR: 2.47 [1.66, 3.68]). Odds of hypertensive disorders of pregnancy increased with advanced maternal age (aOR: 1.79 [1.25, 2.56]), history (aOR: 10.09 [6.77\u201315.04]), and non-White race (aOR: 2.79 [1.95, 4.00]). NICU admission was associated with advanced maternal age (aOR: 1.47 [1.06, 2.02]) and non-White race (aOR: 2.57 [1.84, 3.58]).<\/jats:p><jats:p>\n            Conclusion\u2003Among grand multiparous patients, the risk factor for adverse maternal, obstetric, and neonatal outcomes appears to be occurrence of those adverse events in a prior pregnancy and not increasing parity itself.<\/jats:p><jats:p>\n            Key Points\n          <\/jats:p>","DOI":"10.1055\/a-2223-6093","type":"journal-article","created":{"date-parts":[[2023,12,7]],"date-time":"2023-12-07T01:53:55Z","timestamp":1701914035000},"page":"815-825","source":"Crossref","is-referenced-by-count":5,"title":["Grand Multiparity and Obstetric Outcomes in a Contemporary Cohort: The Role of Increasing Parity"],"prefix":"10.1055","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9532-4109","authenticated-orcid":false,"given":"Chelsea A.","family":"DeBolt","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology and Reproductive Science, Mount Sinai Health System and Icahn School of Medicine at Mount Sinai, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6105-6249","authenticated-orcid":false,"given":"Manasa G.","family":"Rao","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology and Reproductive Science, Mount Sinai Health System and Icahn School of Medicine at Mount Sinai, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3514-1183","authenticated-orcid":false,"given":"Meghana A.","family":"Limaye","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, NYU Grossman School of Medicine, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Viktoriya","family":"London","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Maimonides Medical Center, Brooklyn, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deepika","family":"Sagaram","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology and Women's Health, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashley S.","family":"Roman","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, NYU Grossman School of Medicine, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7800-7195","authenticated-orcid":false,"given":"Howard","family":"Minkoff","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Maimonides Medical Center, Brooklyn, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter S.","family":"Bernstein","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology and Reproductive Science, Mount Sinai Health System and Icahn School of Medicine at Mount Sinai, New York, New York"},{"name":"Department of Obstetrics and Gynecology and Women's Health, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica R.","family":"Overbey","sequence":"additional","affiliation":[{"name":"Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2769-209X","authenticated-orcid":false,"given":"Elianna","family":"Kaplowitz","sequence":"additional","affiliation":[{"name":"Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Meislin","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology and Reproductive Science, Mount Sinai Health System and Icahn School of Medicine at Mount Sinai, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorraine E.","family":"Toner","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology and Reproductive Science, Mount Sinai Health System and Icahn School of Medicine at Mount Sinai, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amrin","family":"Khander","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology and Reproductive Science, Mount Sinai Health System and Icahn School of Medicine at Mount Sinai, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine A.","family":"Bigelow","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology and Reproductive Science, Mount Sinai Health System and Icahn School of Medicine at Mount Sinai, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanne","family":"Stone","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology and Reproductive Science, Mount Sinai Health System and Icahn School of Medicine at Mount Sinai, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2023,12,31]]},"reference":[{"issue":"04","key":"ref1","doi-asserted-by":"crossref","first-page":"244","DOI":"10.5455\/msm.2015.27.244-247","article-title":"Grand multiparity: risk factors and outcome in a tertiary hospital: a comparative study","volume":"27","author":"M A Alsammani","year":"2015","journal-title":"Mater 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