Banks Emily, Meirik Olav, Farley Tim, Akande Oluwole, Bathija Heli, Ali Mohamed
National Centre for Epidemiology and Population Health, Australian National University, ACT 0200, Australia.
Lancet. 2006 Jun 3;367(9525):1835-41. doi: 10.1016/S0140-6736(06)68805-3.
Reliable evidence about the effect of female genital mutilation (FGM) on obstetric outcome is scarce. This study examines the effect of different types of FGM on obstetric outcome.
28 393 women attending for singleton delivery between November, 2001, and March, 2003, at 28 obstetric centres in Burkina Faso, Ghana, Kenya, Nigeria, Senegal, and Sudan were examined before delivery to ascertain whether or not they had undergone FGM, and were classified according to the WHO system: FGM I, removal of the prepuce or clitoris, or both; FGM II, removal of clitoris and labia minora; and FGM III, removal of part or all of the external genitalia with stitching or narrowing of the vaginal opening. Prospective information on demographic, health, and reproductive factors was gathered. Participants and their infants were followed up until maternal discharge from hospital.
Compared with women without FGM, the adjusted relative risks of certain obstetric complications were, in women with FGM I, II, and III, respectively: caesarean section 1.03 (95% CI 0.88-1.21), 1.29 (1.09-1.52), 1.31 (1.01-1.70); postpartum haemorrhage 1.03 (0.87-1.21), 1.21 (1.01-1.43), 1.69 (1.34-2.12); extended maternal hospital stay 1.15 (0.97-1.35), 1.51 (1.29-1.76), 1.98 (1.54-2.54); infant resuscitation 1.11 (0.95-1.28), 1.28 (1.10-1.49), 1.66 (1.31-2.10), stillbirth or early neonatal death 1.15 (0.94-1.41), 1.32 (1.08-1.62), 1.55 (1.12-2.16), and low birthweight 0.94 (0.82-1.07), 1.03 (0.89-1.18), 0.91 (0.74-1.11). Parity did not significantly affect these relative risks. FGM is estimated to lead to an extra one to two perinatal deaths per 100 deliveries.
Women with FGM are significantly more likely than those without FGM to have adverse obstetric outcomes. Risks seem to be greater with more extensive FGM.
关于女性生殖器切割（FGM）对产科结局影响的可靠证据稀缺。本研究探讨不同类型的女性生殖器切割对产科结局的影响。
2001年11月至2003年3月期间，在布基纳法索、加纳、肯尼亚、尼日利亚、塞内加尔和苏丹的28个产科中心，对28393名单胎分娩的妇女在分娩前进行检查，以确定她们是否接受过女性生殖器切割，并根据世界卫生组织系统进行分类：I型女性生殖器切割，切除包皮或阴蒂，或两者皆切除；II型女性生殖器切割，切除阴蒂和小阴唇；III型女性生殖器切割，切除部分或全部外生殖器并缝合或使阴道口变窄。收集了关于人口统计学、健康和生殖因素的前瞻性信息。对参与者及其婴儿进行随访，直至产妇出院。
与未接受女性生殖器切割的妇女相比，I型、II型和III型女性生殖器切割的妇女发生某些产科并发症的校正相对风险分别为：剖宫产1.03（95%CI 0.88-1.21）、1.29（1.09-1.52）、1.31（1.01-1.70）；产后出血1.03（0.87-1.21）、1.21（1.01-1.43）、1.69（1.34-2.12）；产妇住院时间延长1.15（0.97-1.35）、1.51（
