adj.

子供を産んだ、経産の

vaginal injuries may be absent, particularly in parous women(those who have had children).(BBS.196)

関: multipara

WordNet

having given birth to one or more viable children
an eelpout of northern Europe that is viviparous (同)Zoarces viviparus
producing two offspring at a time (同)twinning
producing only one offspring at a time
reproducing by fission

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/05/31 18:25:24」(JST)

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For other uses of the term in other fields, see Parity (disambiguation).

In biology and human medicine, gravidity and parity are two terms that refer to the number of times a female has been pregnant (gravidity) and carried the pregnancies to a viable gestational age (parity).^[1] These terms are usually coupled, sometimes with additional terms, to indicate more details of the woman's obstetric history.^[2] When using these terms:

Gravida indicates the number of times the woman has been pregnant, regardless of whether these pregnancies were carried to term. A current pregnancy, if any, is included in this count.^{[citation needed]}
Parity, or "para" indicates the number of >20-week births (including viable and non-viable; i.e., stillbirths). Pregnancies consisting of multiples, such as twins or triplets, count as one birth for the purpose of this notation.^{[citation needed]}
Abortus is the number of pregnancies that were lost for any reason, including induced abortions or miscarriages. The abortus term is sometimes dropped when no pregnancies have been lost. Stillbirths are not included.^{[citation needed]}

Gravidity

In human medicine, "gravidity" refers to the number of times a woman has been pregnant,^[1] regardless of whether the pregnancies were interrupted or resulted in a live birth.

The term "gravida" can be used to refer to a pregnant woman.
A "nulligravida" is a woman who has never been pregnant.
A "primigravida" is a woman who is pregnant for the first time or has been pregnant one time.
A "multigravida" or "secundogravida" is a woman who has been pregnant more than one time.

Terms such as "gravida 0", referring to a nulligravida, "gravida 1" for a primigravida, and so on, can also be used. The term "elderly primigravida" has also been used to refer to a woman in her first pregnancy, who is at least 35 years old. ^[3]

In biology, the term "gravid" (Latin: gravidus "burdened, heavy"^[4]) is used to describe the condition of an animal (most commonly fish or reptiles) when carrying eggs internally. For example, Astatotilapia burtoni females can transform between reproductive states, one of which is gravid, and the other non-gravid. In entomology it describes a mated female insect.

Parity

Parity is the number of pregnancies carried to viable gestational age.

A woman who has never carried a pregnancy beyond 20 weeks is nulliparous, and is called a nullipara or para 0.^[5] A woman who has given birth once before is primiparous, and is referred to as a primipara or primip; moreover, a woman who has given birth two or more times is multiparous and is called a multip. Finally, grand multipara describes the condition of having given birth three or more times.

Like gravidity, parity may also be counted. A woman who has given birth one or more times can also be referred to as para 1, para 2, para 3 and so on.

Viable gestational age varies from region to region, for example in the UK it is considered to be 24 weeks whilst in the USA 23 weeks is considered viable.^{[citation needed]}

In agriculture, parity is a factor in productivity in domestic animals kept for milk production. Animals that have given birth once are described as "primiparous"; those that have given birth more than once are described as "pluriparous".^[6]^[7] Those that have given birth twice may also be described as "secondiparous", in which case "pluriparous" is applied to those that have given birth three times or more.

Recording systems

A number of systems are incorporated into a woman's obstetric history to record the number of past pregnancies and pregnancies carried to viable age. These include:

The Gravida/para/abortus (GPA) system, or sometimes just gravida/para (GP), is one such shorthand.^{[citation needed]} For example, when recording the history of a woman who has had two pregnancies (both of which resulted in live births) would be noted as G₂P₂. The obstetrical history of a woman who has had four pregnancies, one of which was a miscarriage before 20 weeks, would be noted as G₄P₃A₁ (in the UK this is written as G₄P₃+₁). That of a woman who has had one pregnancy of twins with successful outcomes would be noted as G₁P₂.^[8]
TPAL is one of the methods to provide a quick overview of a female's obstetric history.^[9] In TPAL, the T refers to term births (after 37 weeks gestation), the P refers to premature births, the A refers to abortions, and the L refers to living children.^[10] When reported, the "abortions" number refers to the total number of induced abortions and miscarriages except ectopic pregnancies prior to 20 wks. If a fetus is aborted after 20 wks, spontaneously or electively, then it is counted as a premature birth and P will increase but L will not.^{[citation needed]} The TPAL is described by numbers separated by hyphens. Multiple births (twins, triplets and higher multiples) count as one birth, but each living child is counted separately. For example, a pregnant woman who carried one pregnancy to term with a surviving infant; carried one pregnancy to 35 weeks with surviving twins; carried one pregnancy to 9 weeks as an ectopic (tubal) pregnancy; and has 3 living children would have a TPAL annotation of T1, P1, A1, L3. This could also be written as 1-1-1-3.
The term GTPAL is used when the TPAL is prefixed with gravidity, and "GTPALM" when GTPAL is followed by number of multiple pregnancies.^[10] For example, gravidity and parity of a woman who has given birth at term once and has had one miscarriage at 12 weeks would be recorded as G2 T1 P0 A1 L1. This notation is not standardized and can lead to misinterpretations.^[5]

Though similar, GPA should not be confused with the TPAL system, which may be used to provide information about the number of miscarriages, preterm births, and live births by dropping the "A" and including four separate numbers after the "P", as in G₅P₃₁₁₄. This indicates 5 pregnancies, with 3 term births, 1 preterm birth, 1 induced abortion or miscarriage, and 4 living children.^[11]

Nulliparity

A nulliparous woman (a nullipara or para 0) has never given birth.

Prolonged nulliparity is a risk factor for breast cancer. For instance, a meta-analysis of 8 population-based studies in the Nordic countries found that nulliparity was associated with a 30% increase in risk of breast cancer compared with parous women, and for every 2 births, the risk was reduced by about 16%. Women having their first birth after the age of 35 years had a 40% increased risk compared to those with a first birth before the age of 20 years.^[12]

Criticism

In humans, it can lead to some ambiguity for events occurring between 20 and 24 weeks,^[13] and for multiple pregnancies.^[14]

References

^ ^a ^b Borton, Chloe (November 12, 2009). "Gravidity and Parity Definitions (and their Implications in Risk Assessment)". Patient.co.uk. Retrieved June 26, 2013.
^ Creinin, MD; Simhan, HN (Mar 2009). "Can we communicate gravidity and parity better?". Obstetrics and gynecology 113 (3): 709–11. doi:10.1097/AOG.0b013e3181988f8f. PMID 19300338.
^ Brassil MJ, Turner MJ, Egan DM, MacDonald DW; Turner; Egan; MacDonald (June 1987). "Obstetric outcome in first-time mothers aged 40 years and over". European Journal of Obstetrics & Gynecology and Reproductive Biology 25 (2): 115–20. doi:10.1016/0028-2243(87)90114-6. PMID 3609426.
^ Oxford English Dictionary^{[page needed]}
^ ^a ^b F. Gary Cunningham, 2005. Williams Obstetrics, 22nd Edition, McGraw-Hill Companies.
^ Mehrzad J, Duchateau L, Pyörälä S, Burvenich C. (2002). Blood and milk neutrophil chemiluminescence and viability in primiparous and pluriparous dairy cows during late pregnancy, around parturition and early lactation. Journal of Dairy Science "85" (12): 3268-76.
^ D. Vecchio, G. Neglia, M. Rendina, M. Marchiello, A. Balestrieri, R. Di Palo (2007). Dietary influence on primiparous and pluriparous buffalo fertility. Italian Journal of Animal Science "6" (Suppl. 1): 512–514.
^ Hatfield, Nancy; N. Jayne Klossner (2006). Introductory maternity & pediatric nursing. Hagerstown, MD: Lippincott Williams & Wilkins. p. 142. ISBN 0-7817-3690-0.
^ http://www.meddean.luc.edu/lumen/MedEd/obgyne/tools.pdf^{[full citation needed]}
^ ^a ^b Lippincott Manual of Nursing Practice Series: Assessment. Lippincott Manual of Nursing Practice. Hagerstwon, MD: Lippincott Williams & Wilkins. 2006. p. 385. ISBN 1-58255-939-2.
^ Bardsley CR (2011). "Normal Pregnancy". In Tintinalli JE, Kelen GD, Stapczynski JS. Tintinalli's Emergency Medicine: A Comprehensive Study Guide (7th ed.). New York: McGraw-Hill.
^ Ewertz M, Duffy SW, Adami HO et al. (1990). "Age at first birth, parity and risk of breast cancer: A meta-analysis of 8 studies from the Nordic countries". International Journal of Cancer 46 (4): 597–603. doi:10.1002/ijc.2910460408. PMID 2145231.
^ Creinin MD, Simhan HN; Simhan (March 2009). "Can we communicate gravidity and parity better?". Obstet Gynecol 113 (3): 709–11. doi:10.1097/AOG.0b013e3181988f8f. PMID 19300338.
^ Opara EI, Zaidi J; Zaidi (October 2007). "The interpretation and clinical application of the word 'parity': a survey". BJOG 114 (10): 1295–7. doi:10.1111/j.1471-0528.2007.01435.x. PMID 17877683.

UpToDate Contents

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1. 妊娠および出産に関連した尿失禁および骨盤臓器脱 urinary incontinence and pelvic organ prolapse associated with pregnancy and childbirth
2. 妊娠および経膣分娩が肛門括約筋および便失禁に及ぼす影響 effect of pregnancy and childbirth on anal sphincter function and fecal incontinence
3. 乳房の発達および形態 breast development and morphology
4. 多経産 grand multiparity
5. 非哺乳期の乳腺炎 nonlactational mastitis

English Journal

Breast cancer and ages at first marriage and first birth: a new hypothesis.

Kinlen LJ.Author information Cancer Epidemiology Unit, Nuffield Department of Medicine, University of Oxford, Oxford, UK.AbstractThe aim of this study was to examine available data on breast cancer and age at first marriage from a new perspective: that is, marriage involves the closest contact and contact effects are relevant to the question of infection, a possibility long considered in this disorder. The large Seven Country Study, carried out in 1964-1968, investigated age at first marriage; its reports were examined carefully for details of possible relevance. Intriguing gaps were noted in the grounds for the conclusion by this study that late age at first birth explained an earlier reported association with late age at marriage, with risks presented by age at first marriage for nulliparous, but not for parous, married women. Only in one centre, Glamorgan Wales, and only for two age groups could risks by combined ages at first marriage and first birth be derived. When both events occurred at age 30 or older, the risk estimate was 7.0 (95% confidence interval: 5.2, 9.1) relative to when both events occurred younger than age 20, whereas the corresponding risk was 1.4 (95% confidence interval: 1.1, 1.8) when age at first birth was 30 or older but marriage was younger than age 30. The above findings are consistent with an effect of age at first marriage, and a basis in contacts or infection is considered plausible. However, other explanations may exist, and this report primarily aims to encourage examination of the subject in other datasets, particularly where intersexual contrasts in infective exposures have probably existed.
European journal of cancer prevention : the official journal of the European Cancer Prevention Organisation (ECP).Eur J Cancer Prev.2014 Jan;23(1):53-7. doi: 10.1097/CEJ.0b013e3283627ef5.
The aim of this study was to examine available data on breast cancer and age at first marriage from a new perspective: that is, marriage involves the closest contact and contact effects are relevant to the question of infection, a possibility long considered in this disorder. The large Seven Country
PMID 23695810

IVF and breast cancer: a systematic review and meta-analysis.

Sergentanis TN, Diamantaras AA, Perlepe C, Kanavidis P, Skalkidou A, Petridou ET.Author information Department of Hygiene, Epidemiology and Medical Statistics, Medical School, University of Athens, 75 M. Asias Str. Goudi, Athens 115 27, Greece.AbstractBACKGROUND The effects of controlled ovarian hyperstimulation (COH) for IVF in terms of breast cancer risk remain controversial, despite the hormone-dependent nature of the latter. METHODS Eligible studies up to 15 February 2013 were identified and pooled effect estimates for relative risk (RR) were calculated separately for the investigations using the general population and those using infertile women, as a reference group. Fixed- or random-effects models were implemented and subgroup analyses were performed, as appropriate. RESULTS Eight cohort studies were synthesized, yielding a total cohort size of 1 554 332 women among whom 14 961 incident breast cancer cases occurred, encompassing 576 incident breast cancer cases among women exposed to IVF. No significant association between IVF and breast cancer was observed either in the group of studies treating the general population (RR = 0.91, 95% confidence interval (CI): 0.74-1.11) or infertile women (RR = 1.02, 95% CI: 0.88-1.18), as a reference group. Of note were the marginal associations, protective for pregnant and/or parous women after IVF (pooled effect estimate = 0.86, 95% CI: 0.73-1.01) and adverse for women <30 years at first IVF treatment (pooled effect estimate = 1.64, 95% CI: 0.96-2.80). CONCLUSIONS At present, COH for IVF does not seem to impart increased breast cancer risk. Longer follow-up periods, comparisons versus infertile women, subgroup analyses aiming to trace vulnerable subgroups, adjustment for various confounders and larger informative data sets are needed before conclusive statements for the safety of the procedure are reached.
Human reproduction update.Hum Reprod Update.2014 Jan-Feb;20(1):106-23. doi: 10.1093/humupd/dmt034. Epub 2013 Jul 24.
BACKGROUND The effects of controlled ovarian hyperstimulation (COH) for IVF in terms of breast cancer risk remain controversial, despite the hormone-dependent nature of the latter. METHODS Eligible studies up to 15 February 2013 were identified and pooled effect estimates for relative risk (RR) were
PMID 23884897

Anxiety and anxiety sensitivity as predictors of fear of childbirth: different patterns for nulliparous and parous women.

Jokić-Begić N, Zigić L, Nakić Radoš S.Author information Department of Psychology, Faculty of Humanities and Social Sciences, University of Zagreb , Zagreb , Croatia .AbstractAbstract Objective: The demographic characteristics, maternal parity and personal traits of pregnant women have been frequently studied predictors of fear of childbirth (FOC). The aim of this study was to examine the role of demographic variables, expected pain level, trait anxiety and anxiety sensitivity in FOC among nulliparous and multiparous women in the last trimester of pregnancy. Method: Two-hundred pregnant women completed a booklet with questionnaires including the Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ), Anxiety Sensitivity Index (ASI), The State - Trait Anxiety Inventory (STAI) and questions on expected labor pain and demographics. Results: Results showed that FOC was higher amongst nulliparous women, but FOC level was not associated with other demographic variables. Different predictors were established in nulliparous and multiparous women. While higher intensity of expected labor pain and anxiety sensitivity (dimension physical concern) were significant predictors in both groups, trait anxiety was significant for the first-time mothers only. Conclusion: Amongst all women, anxiety sensitivity (physical concerns dimension) was identified as an important vulnerability factor for FOC. As such, the level of anxiety sensitivity, and any resulting fear or expectations of pain, should be assessed in expectant mothers by clinicians in prenatal settings. Furthermore, anxiety sensitivity should be an important target for psychological interventions aimed at managing FOC.
Journal of psychosomatic obstetrics and gynaecology.J Psychosom Obstet Gynaecol.2013 Dec 13. [Epub ahead of print]
Abstract Objective: The demographic characteristics, maternal parity and personal traits of pregnant women have been frequently studied predictors of fear of childbirth (FOC). The aim of this study was to examine the role of demographic variables, expected pain level, trait anxiety and anxiety sensi
PMID 24328559

Japanese Journal

血液透析下にパクリタキセル・カルボプラチン療法を施行した慢性腎不全合併卵巣癌の1症例

福井薫,山口博文,串本卓哉,梅田杏奈,数見久美子,宮西加寿也,朴康誠,山本敏也
産婦人科の進歩 65(1), 90-94, 2013
慢性腎不全維持透析中の卵巣癌患者に対し，パクリタキセルとカルボプラチン併用化学療法を行い，緩解を得た症例を経験したので報告する．症例は73歳，1回経妊，1回経産．61歳より慢性糸球体腎炎にて血液透析を施行している．下腹部痛の精査の結果，上行結腸～S状結腸，右付属器および肝臓に腫瘍を認め，CA125高値であったため，外科とともに開腹術施行．術後診断は卵巣癌IV期で，術後化学療法としてパクリタキセル・ …
NAID 130003362658

乾乳期間の短縮(40日間)が乳牛の泌乳成績, 繁殖成績および健康状態に及ぼす影響

山科一樹,吉村義久,生田健太郎 [他],丸山朝子,村中洋美,時田康広,加藤和雄,田鎖直澄,寺田文典
日本畜産學會報 = The Japanese journal of zootechnical science 83(4), 363-372, 2012-11-25
ホルスタイン種乳用牛において乾乳期間の短縮が，乳牛の泌乳成績，繁殖成績および健康状態に及ぼす影響を，乾乳期間を40日に短縮した乳牛群（短縮区）と乾乳期間60日の牛群（慣行区）を設定し，比較検討した．2産以上かつ分娩予定60日前に約20kg/日以上泌乳しているウシを短縮区21頭，慣行区20頭供試した．実乾乳期間は，短縮区40.7日，慣行区61.4日となった．短縮区における搾乳期間延長（3週間）に伴う …
NAID 10031130484

Death of a Son is Associated With Risk of Suicide Among Parous Women in Taiwan : A Nested Case-Control Study

CHEN Chih-Cheng,KUO Chien-Chun,WU Trong-Neng,YANG Chun-Yuh
Journal of epidemiology 22(6), 532-536, 2012-11-01
… We examined whether the death of a child, especially a son, increased the risk of suicide among parous Taiwanese women.<BR>Methods: This matched case-control study was done within a cohort of 1 292 462 Taiwanese women who experienced a first and singleton childbirth between 1 January 1978 and 31 December 1987 and were followed up until 31 December 2008. …
NAID 10031126936