Boghossian Araz S, Freebody John, Moses Rebecca, Jenkins Gregory
Department of Obstetrics and Gynaecology, Westmead Hospital, Sydney, Australia.
Department of Radiology, St Vincent's Hospital, Sydney, Australia.
Aust N Z J Obstet Gynaecol. 2020 Feb;60(1):76-81. doi: 10.1111/ajo.13001. Epub 2019 Jun 13.
Although prohibited by specific legislation in Australia, patterns of global migration underscore the importance for local clinicians to recognise and manage potential complications associated with female genital mutilation/cutting (FGM/C). The incidence of antenatal depression in Australia is 10% and may be higher among those with a history of FGM/C (RANZCOG 2 statement: Perinatal Anxiety and Depression, 2012). The phenomenon of cultural embedding could represent a protective factor against an increase in mental health problems among these women.
To determine whether women who have undergone FGM/C are at greater risk of depression in the antenatal period as defined by the Edinburgh Postnatal Depression Scale (EPDS).
A multicentre retrospective case-control study was performed. Participants who had delivered at either of two hospitals, had migrated from FGM/C-prevalent countries and who had undergone FGM/C were assessed and compared with the control group, case-matched by language and religion.
Eighty-nine cases were included with an equal number of matched controls. No significant difference in the EPDS score was demonstrated when analysed as a continuous variable (P = 0.41) or as a categorical variable with a cut-off score of 12 (P = 0.12). There was no difference in the number of women who identified as having thoughts of self-harm between the two groups.
There was no identified increase in the risk of antenatal depression among women who have undergone FGM/C from high-prevalence countries. Consideration must be given to the utility of the EPDS in this population, as well as factors such as cultural embedding.
尽管澳大利亚有特定法律禁止女性生殖器切割，但全球移民模式凸显了当地临床医生认识和处理与女性生殖器切割（FGM/C）相关潜在并发症的重要性。澳大利亚产前抑郁症的发病率为10%，在有女性生殖器切割史的人群中可能更高（澳大利亚皇家妇产科医师学院声明2：围产期焦虑和抑郁，2012年）。文化嵌入现象可能是这些女性心理健康问题增加的一个保护因素。
确定根据爱丁堡产后抑郁量表（EPDS）定义，接受过女性生殖器切割的女性在孕期患抑郁症的风险是否更高。
进行了一项多中心回顾性病例对照研究。对在两家医院之一分娩、从女性生殖器切割盛行国家移民且接受过女性生殖器切割的参与者进行评估，并与按语言和宗教进行病例匹配的对照组进行比较。
纳入89例病例，匹配对照组数量相同。将EPDS评分作为连续变量分析时（P = 0.41）或作为截断分数为12的分类变量分析时（P = 0.12），均未显示出显著差异。两组中表示有自我伤害想法的女性数量没有差异。
来自高流行国家且接受过女性生殖器切割的女性，未发现其产前抑郁症风险增加。必须考虑EPDS在该人群中的效用，以及文化嵌入等因素。
