Background: While grand multiparity is low in developed nations, it is still a common condition in developing countries. Recent reports fail to show clear evidence on the contribution of grand multiparity to adverse pregnancy outcomes. This study aimed to compare maternal and perinatal outcomes in grand multiparous and low multiparity women in Hawassa University comprehensive specialized hospital and Adare General Hospital.

Methods: Comparative cross-sectional study design was employed from February to June 2018. Four hundred seventy one (471) mothers (157 grand multiparas & 314 low multiparas) were included. Data were collected by structured questionnaire using interview and from patient charts. Data were entered and analyzed using EPI-DATA v 4.4.2.0 and STATA v 14.1 respectively.

Results: About 39% (95% Confidence interval: 34.6%-43.5%) and nearly one-fourth (24.9%) (95% Confidence interval: 21.1%-29.1%) mothers had at least one adverse maternal and perinatal outcome, respectively. Previous medical illnesses [adjusted OR: 3.07 95% CI 1.19, 7.90], previous cesarean delivery [adjusted OR: 7.85 95% CI 3.42, 18.00] and high birth weight [adjusted OR: 3.91 95% CI 1.21, 12.61] were independent predictors of adverse maternal outcome. Mothers’ education level, income and low birth weight also statistically significant variables with adverse maternal outcome. Similarly, less than four prenatal visit and previous home delivery were independent predictors of adverse perinatal outcome (AOR: 1.74 95% CI 1.04, 2.92 and 1.87: 1.04, 3.33, respectively). However, parity did not show statistically significant difference in both maternal and perinatal outcomes.

Conclusion and recommendations: This study identified socio-economic and obstetric independent predictors of adverse pregnancy outcomes. However, parity did not show statistically significant difference in pregnancy outcomes. Women empowerment, promoting health facility delivery and meticulous counseling on the advantage of prenatal care, high-risk conditions are recommended. Further large-scale researches are needed to support this finding.

Key words: maternal outcome, perinatal outcome, parity