This population-based cohort study was conducted to compare pregnancy
complications and outcome among nulliparous, low (1-5) and high
(≥ 6) parity women. Women who registered for antenatal care and
gave birth in Gutu District, Zimbabwe, between January 1995 and June
1998 were classified into groups by parity. The women were compared for
baseline characteristics, utilisation of health facilities and
occurrence of pregnancy complications such as hypertensive disorders of
pregnancy, haemorrhage, pre-term delivery, operative delivery, low
birth weight and perinatal death. In estimating risk, primiparous
(parity = 1) women were used as referents. Pregnancy records for 10,569
women were analysed. Mean ages of nulliparous and high parity (≥
6) women were 20.1 and 37.7 years respectively (p < 0.001).
Prevalence of anaemia at booking (haemoglobin ≤10.5 g/dl) was
reduced in nulliparous compared to multiparous women (11.7% vs 16.8%; p
≥ 0.001). Nulliparous women were likely to book early (≤ 20
weeks) for antenatal care, have a higher number of visits (≥ 6)
and fewer home births. Nulliparous women had higher risk for low birth
weight (RR 1.70; 95% CI 1.36 - 2.13). Compared to low parity women,
nulliparous and high parity women had an elevated risk of hypertensive
complications RR 1.62 (95% CI 1.37-1.92) and RR 1.64 (95% CI 1.29 -
2.07) respectively. The risk of developing any pregnancy complications
was highest in nulliparous women (RR 1.48; 95% 1.31- 1.67). In
conclusion, nulliparous women had an increased risk of pregnancy
complications. High parity women with no previous complicated pregnancy
were at low risk of complications. (Afr J Reprod Health 2004; 8[3]
198-206