Maternity Department, Victoria Hospital, NHS Fife, Kirkcaldy, UK.
NHS Borders, Borders General Hospital, Melrose, UK.
Eur J Public Health. 2018 Aug 1;28(4):657-661. doi: 10.1093/eurpub/cky045.
Female genital mutilation (FGM) is most commonly encountered in Africa and the Middle East, with migration from FGM-practicing countries meaning it is increasingly seen in Europe. Addressing FGM requires accurate information on who is affected but ascertainment is notoriously difficult. This study estimated FGM prevalence in women presenting for maternity care in the Lothian region of Scotland and compared this with that expected by extrapolation of survey data from women's country of birth.
Electronic clinical records were linked to birth registration data to estimate FGM in the obstetric patients in Lothian from 2010 to 2013.
Among all, 107 women affected by FGM were detected, at a rate of 2.8/1000 pregnancies. Of 487 women from UNICEF-recognized FGM-practicing countries who accessed care, 87 (18%) had documented evidence of FGM (three quarters of whom came from Nigeria, Sudan or The Gambia). The prevalence was 54% of the level expected from the extrapolation method. Country of birth had a sensitivity of 81% for FGM.
Women from FGM-practicing countries commonly access maternity care in Lothian. This confirms the need for ongoing training and investment in identifying and managing FGM. Matching electronic clinical records with birth registration data was a useful methodology in estimating the level of FGM in the maternity population. In a European country like Scotland with modest migrant numbers, asking country of birth during pregnancy and making sensitive enquiries could detect 81% of women with FGM. Extrapolation from maternal country of birth surveys grossly overestimates the true prevalence.
女性生殖器切割（FGM）在非洲和中东最为常见，由于来自实行女性生殖器切割国家的移民，这种情况在欧洲也越来越常见。解决女性生殖器切割问题需要准确了解受影响的人群，但这种确定方法非常困难。本研究估计了苏格兰洛锡安区产妇护理中女性生殖器切割的流行率，并将其与从女性出生地调查数据推断的预期流行率进行了比较。
电子临床记录与出生登记数据相关联，以估计 2010 年至 2013 年洛锡安区产科患者中的女性生殖器切割情况。
在所有患者中，共发现 107 名受女性生殖器切割影响的患者，患病率为每 1000 例妊娠 2.8 例。在接受护理的 487 名来自联合国儿童基金会认可的实行女性生殖器切割国家的妇女中，有 87 人（18%）有记录证明实施了女性生殖器切割（其中四分之三来自尼日利亚、苏丹或冈比亚）。实际流行率是从推断方法得出的预期水平的 54%。出生地的敏感性为 81%。
来自实行女性生殖器切割国家的妇女通常在洛锡安区接受产妇护理。这证实了需要不断培训并投资于识别和管理女性生殖器切割。将电子临床记录与出生登记数据相匹配是一种估计产妇群体中女性生殖器切割水平的有用方法。在像苏格兰这样移民人数适中的欧洲国家，在怀孕期间询问出生地并进行敏感询问可以发现 81%的女性生殖器切割者。从产妇母国的调查推断出的流行率严重高估了真实情况。
