Pallitto Christina, Ruiz-Vallejo Fernando, Mochache Vernon, Stein Karin, Vogel Joshua P, Petzold Max
Department of Sexual and Reproductive Health and Research, and the UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, 20 Avenue Appia, Geneva, 1211, Switzerland.
Facultad de Medicina, Universidad Nacional de Colombia, Bogota, Colombia.
BMC Public Health. 2025 Apr 14;25(1):1387. doi: 10.1186/s12889-025-21584-z.
Female genital mutilation (FGM) is a harmful practice that affects an estimated 230 million women and girls. Previous research indicates that FGM is associated with increased risk of short- and long-term health complications. Understanding the health complications is important in ensuring high quality care for women and girls already affected and for advocating for prevention of the practice.
The objective of this study was to conduct a systematic review and meta-analysis of all existing evidence on the association between FGM and a range of health complications.
We conducted a systematic review of the literature on the health complications of FGM published between February 2009 and December 2022, applying search strategies and terms aligned with previous reviews. We identified studies that compared women with various types of FGM versus those without for six domains of health complications (i.e., immediate, obstetric & neonatal, gynecological, urological, sexual and mental). Random effects meta-analysis was conducted by health condition and FGM type. Immediate health complications were analysed separately based on data from population-based surveys.
We analysed data from 78 studies (n = 486,949), of which 67 informed the meta-analyses comparing women with and without FGM and 11 informed analyses on the immediate health complications. Most of the studies (N = 68) were conducted in high FGM prevalence countries. Among women and girls living with FGM compared to those without, we found an increased risk for obstetric complications, including prolonged/obstructed labor, obstetric tears, caesarean birth, postpartum hemorrhage, episiotomy, fetal distress, extended maternal hospital stay, neonatal asphyxia, and stillbirth/neonatal death; gynecological complications, including genital tissue damage, genitourinary tract infections, and menstrual difficulties; urological complications, including urinary tract infections and difficulty urinating; sexual complications including dyspareunia and sexual dysfunction; and mental health complications including depression or anxiety and somatoform disorder.
These results support results from previous research finding an association between FGM and a range of health complications over the life course. This calls for strengthening health systems to provide high-quality care for women and girls at-risk of or affected by FGM and ensuring that FGM prevention and care services are included in essential health service packages.
女性生殖器切割是一种有害行为，估计影响着2.3亿妇女和女童。先前的研究表明，女性生殖器切割与短期和长期健康并发症风险增加有关。了解这些健康并发症对于确保为已经受影响的妇女和女童提供高质量护理以及倡导预防这种行为至关重要。
本研究的目的是对所有关于女性生殖器切割与一系列健康并发症之间关联的现有证据进行系统评价和荟萃分析。
我们对2009年2月至2022年12月期间发表的关于女性生殖器切割健康并发症的文献进行了系统评价，采用了与先前评价一致的检索策略和术语。我们确定了将不同类型女性生殖器切割的女性与未进行切割的女性在六个健康并发症领域（即即时、产科与新生儿、妇科、泌尿科、性健康和心理健康）进行比较的研究。按健康状况和女性生殖器切割类型进行随机效应荟萃分析。根据基于人群调查的数据对即时健康并发症进行单独分析。
我们分析了78项研究（n = 486,949）的数据，其中67项为比较有和没有女性生殖器切割的女性的荟萃分析提供了信息，11项为即时健康并发症分析提供了信息。大多数研究（N = 68）在女性生殖器切割流行率高的国家进行。与未进行女性生殖器切割的妇女和女童相比，我们发现进行过女性生殖器切割的妇女和女童出现产科并发症的风险增加，包括产程延长/梗阻、产科撕裂、剖宫产、产后出血·、会阴切开术、胎儿窘迫、产妇住院时间延长·、新生儿窒息以及死产/新生儿死亡；妇科并发症，包括生殖器组织损伤、泌尿生殖道感染和月经困难；泌尿科并发症，包括尿路感染和排尿困难；性健康并发症，包括性交疼痛和性功能障碍；以及心理健康并发症，包括抑郁或焦虑和躯体形式障碍。
这些结果支持了先前的研究结果，即女性生殖器切割与一生中一系列健康并发症之间存在关联。这就要求加强卫生系统，为有女性生殖器切割风险或受其影响的妇女和女童提供高质量护理，并确保将女性生殖器切割预防和护理服务纳入基本卫生服务包。
