Original Contribution Cause-specific Mortality of Grand Multiparous Women in Finland

Knowledge is limited on mortality of grand multiparous women ( 5 deliveries), whose hormonal, metabolic, and social conditions differ from the average. The authors studied overall and cause-specific mortality in 1974–2001 among 87,922 grand multiparous women including 3,678 grand grand multiparous women ( 10 deliveries) in Finland. Standardized mortality ratios were defined as ratios of observed to expected numbers of deaths, both derived from national cause-of-death files. During follow-up, 18,870 grand multiparous women and 625 grand grand multiparous women died (standardized mortality ratios (SMRs) 1⁄4 0.95 and 1.01, respectively). Decreased mortality among grand multiparous women was found for cancers of the breast (SMR 1⁄4 0.64, 95% confidence interval (CI): 0.59, 0.69), corpus uteri (SMR 1⁄4 0.68, 95% CI: 0.56, 0.80), ovary (SMR 1⁄4 0.68, 95% CI: 0.60, 0.75), bladder (SMR 1⁄4 0.59, 95% CI: 0.41, 0.82), and respiratory tract (SMR 1⁄4 0.80, 95% CI: 0.72, 0.88). The only malignant tumor associated with elevated mortality was kidney cancer (SMR 1⁄4 1.38, 95% CI: 1.21, 1.56). The standardized mortality ratio was also low for dementia (SMR 1⁄4 0.78, 95% CI: 0.72, 0.84), respiratory diseases (SMR 1⁄4 0.80, 95% CI: 0.75, 0.85), and accidents and violent causes (SMR 1⁄4 0.79, 95% CI: 0.73, 0.84). Mortality from diabetes mellitus (SMR 1⁄4 1.42, 95% CI: 1.29, 1.55) and ischemic heart disease (SMR 1⁄4 1.10, 95% CI: 1.08, 1.13) was increased. According to this study, overall mortality among grand multiparous women is not elevated. Low mortality from cancers is offset by higher mortality from cardiovascular conditions and diabetes mellitus.