Minsart Anne-Frederique, N'guyen Thai-Son, Ali Hadji Rachid, Caillet Martin
a Department of Gynecology and Obstetrics , Affi Hospital , Djibouti-City , Republic of Djibouti and.
J Matern Fetal Neonatal Med. 2015;28(14):1741-6. doi: 10.3109/14767058.2014.967676. Epub 2014 Oct 9.
The objective of the present study was to assess the relation between female genital mutilation and obstetric outcome in an East African urban clinic with a standardized care, taking into account medical and socioeconomic status.
This was a cohort study conducted in Djibouti between October 1, 2012 and April 30, 2014. Overall 643 mothers were interviewed and clinically assessed for the presence of female genital mutilation. The prevalence of obstetric complications by infibulation status was included in a multivariate stepwise regression model.
Overall, 29 of 643 women did not have any form of mutilation (4.5%), as opposed to 238 of 643 women with infibulation (37.0%), 369 with type 2 (57.4%), and 7 with type 1 mutilation (1.1%).Women with a severe type of mutilation were more likely to have socio-economic and medical risk factors. After adjustment, the only outcome that was significantly related with infibulation was the presence of meconium-stained amniotic fluid with an odds ratio of 1.58 (1.10-2.27), p value=0.014.
Infibulation was not related with excess perinatal morbidity in this setting with a very high prevalence of female genital mutilation, but future research should concentrate on the relation between infibulation and meconium.
本研究的目的是在一家提供标准化护理的东非城市诊所中,评估女性生殖器切割与产科结局之间的关系,同时考虑医疗和社会经济状况。
这是一项于2012年10月1日至2014年4月30日在吉布提进行的队列研究。总共对643名母亲进行了访谈,并对其是否存在女性生殖器切割进行了临床评估。按闭锁缝合状态划分的产科并发症患病率被纳入多元逐步回归模型。
总体而言,643名女性中有29名未遭受任何形式的切割(4.5%),相比之下,643名女性中有238名接受了闭锁缝合(37.0%),369名接受了2型切割(57.4%),7名接受了1型切割(1.1%)。遭受严重切割类型的女性更有可能存在社会经济和医疗风险因素。调整后,与闭锁缝合显著相关的唯一结局是羊水粪染,比值比为1.58(1.10 - 2.27),p值 = 0.014。
在女性生殖器切割患病率极高的这种情况下,闭锁缝合与围产期发病率过高无关,但未来的研究应集中在闭锁缝合与胎粪之间的关系上。