Advanced maternal age, multiparity
and pre-eclampsia are well-established risk factors for peripartum cardiomyopathy.
These health consequences have led to mortality in up to 24% of women.5 A study in Pakistan identified the risk factors in postmenopausal women who had osteoporotic hip fractures and they identified that advancing age, early menopause, low BMI, longer duration of menopause, smoking, poor socioeconomic conditions, illiteracy, multiparity
, lack of calcium supplements, injudicious use of steroids are the important risk factors.6 Alkaline phosphatase (ALP), a homodimeric protein with phosphorylating properties exist in many isozyme forms, the most common of them being tissue non-specific ALP.
This could be due to diabetes and grand multiparity
as a significant number of their study cases were older than 40 years of age.
 Grand multiparity
has been considered an independent factor for increasing adverse outcome for both fetus and mother specially diabetes mellitus, antepartum haemorrhage, mal-presentation, caesarean section rate, postpartum haemorrhage, iron deficiency anaemia, and a high perinatal mortality rate.
On multivariate analysis, multiparity
, greater cervical dilatation after balloon removal and the use of epidural analgesia were associated with a decreased risk of CS, whereas the presence of GDM and oligohydramnios was associated with an increased risk of CS (Table 2).
(4) Maternal factors associated with breech presentation include nulliparity, multiparity
, previous breech birth, contracted maternal pelvis, uterine anomalies, use of anticonvulsant drugs, placenta previa, and cornual placenta.
Bashir Bhatti's study had a huge percentage of iron deficiency anemia as 57 with multiparity
as the risk factor and frequency of iron deficiency anemia maximum in age groups 15-30 years of age, which is in accordance with the present study findings of 54% iron deficiency anemia in pregnant females, women with more than 3 children being the most affectees and vulnerable age groups as 20-39 years.
These factors might include maternal health condition before and during pregnancy, multiparity
, and other cytokine levels during pregnancy such as leptin, interferon gamma etc.
The literature has identified several socioeconomic factors associated with accidental or unplanned home birth, including single motherhood, maternal unemployment, low educational attainment, and multiparity
Of note, however, in a multivariate analysis fully adjusted for standard cardiovascular risk factors, as well as hypercoagulability, preterm birth, grand multiparity
, and insurance status, placental abruption was independently associated with a 2.14-fold risk of MINOCA, but it was no longer linked to significantly increased risks of the other cardiovascular events.
The overall violence before pregnancy was significantly associated with multiparity
(p<0.001), marriage type (p=0.008), women's educational status (p=0.004), and their partners' educational status (p=0.002).
Face presentation is associated with multiparity
, macrosomia, cephalopelvic disproportion, prematurity, polyhydramnios, and fetal anomalies (such as anencephaly or cervical mass) (9).