Partnership for Maternal, Newborn and Child Health, Geneva, Switzerland.
Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland.
Reprod Health. 2020 May 20;17(1):68. doi: 10.1186/s12978-020-00918-7.
Studies have shown the impact of female genital mutilation (FGM), especially infibulation (WHO type III), on reproductive health, and adverse obstetric outcomes like postpartum haemorrhage and obstructed labour. However, whether an association exists with maternal hypertensive complication is not known. The present study sought to investigate the role of the different types of FGM on the occurrence of eclampsia.
The study used data from the 2006 Demographic and health survey of Mali. The proportion of eclampsia in women with each type of FGM and the unadjusted and adjusted odds ratios (OR) were calculated, using women without FGM as reference group. Unadjusted and adjusted OR were also calculated for women who underwent infibulation compared to the rest of the population under study (women without FGM and women with FGM type I, II, and IV).
In the 3997 women included, the prevalence of infibulation was 10.2% (n = 407) while 331 women did not report FGM (8.3%). The proportion of women reporting signs and symptoms suggestive of eclampsia was 5.9% (n = 234). Compared with the absence of female genital mutilation and adjusted for covariates, infibulation was associated with eclampsia (aOR 2.5; 95% CI:1.4-4.6), while the association was not significant in women with other categories of FGM. A similar aOR was found when comparing women with infibulation with the pooled sample of women without FGM and women with the other forms of FGM.
The present study suggests a possible association between infibulation and eclampsia. Future studies could investigate this association in other settings. If these findings are confirmed, the possible biological mechanisms and preventive strategies should be investigated.
研究表明，女性生殖器切割（FGM），尤其是会阴缝合（世卫组织 III 型），对生殖健康以及产后出血和产道梗阻等不良产科结局有影响。然而，其与产妇高血压并发症之间是否存在关联尚不清楚。本研究旨在探讨不同类型的 FGM 对子痫前期发生的影响。
本研究使用了马里 2006 年人口与健康调查的数据。计算了每一种 FGM 类型的子痫前期比例，以及未接受 FGM 的妇女作为参考组的未调整和调整后的比值比（OR）。还计算了与研究人群中其他妇女（未接受 FGM 的妇女和接受 I 型、II 型和 IV 型 FGM 的妇女）相比，接受会阴缝合的妇女的未调整和调整后的 OR。
在 3997 名妇女中，会阴缝合的流行率为 10.2%（n=407），而 331 名妇女未报告 FGM（8.3%）。报告有子痫前期症状和体征的妇女比例为 5.9%（n=234）。与不存在女性生殖器切割且调整了混杂因素相比，会阴缝合与子痫前期相关（调整后的比值比 2.5；95%置信区间：1.4-4.6），而其他类型的 FGM 与子痫前期之间的关联不显著。当比较接受会阴缝合的妇女与未接受 FGM 和其他形式 FGM 的妇女的总样本时，也发现了相似的调整后比值比。
本研究提示会阴缝合与子痫前期之间可能存在关联。未来的研究可以在其他环境中调查这种关联。如果这些发现得到证实，应调查可能的生物学机制和预防策略。
