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Risk of obstetric anal sphincter injury associated with female genital mutilation/cutting and timing of deinfibulation

INTRODUCTION: A greater risk of obstetric anal sphincter injury has been reported among African migrants in several host countries compared with the general population. To what degree female genital mutilation/cutting affects this risk is not clear. In infibulated women, deinfibulation prevents anal...

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Autores principales: Taraldsen, Sølvi, Vangen, Siri, Øian, Pål, Sørbye, Ingvil K.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9812199/
https://www.ncbi.nlm.nih.gov/pubmed/35946127
http://dx.doi.org/10.1111/aogs.14424
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author Taraldsen, Sølvi
Vangen, Siri
Øian, Pål
Sørbye, Ingvil K.
author_facet Taraldsen, Sølvi
Vangen, Siri
Øian, Pål
Sørbye, Ingvil K.
author_sort Taraldsen, Sølvi
collection PubMed
description INTRODUCTION: A greater risk of obstetric anal sphincter injury has been reported among African migrants in several host countries compared with the general population. To what degree female genital mutilation/cutting affects this risk is not clear. In infibulated women, deinfibulation prevents anal sphincter injury. Whether the timing of deinfibulation affects the risk, is unknown. This study aimed to investigate the risks of anal sphincter injury associated with female genital mutilation/cutting and timing of deinfibulation in Norway, and to compare the rates of anal sphincter injury in Somali‐born women and the general population. MATERIAL AND METHODS: In a historical cohort study, nulliparous Somali‐born women who had a vaginal birth in the period 1990–2014 were identified by the Medical Birth Registry of Norway and data collected from medical records. Exposures were female genital mutilation/cutting status and deinfibulation before labor, during labor or no deinfibulation. The main outcome was obstetric anal sphincter injuries. RESULTS: Rates of obstetric anal sphincter injury did not differ significantly by female genital mutilation/cutting status (type 1–2: 10.2%, type 3: 11.3%, none: 15.2% P = 0.17). The total rate of anal sphincter injury was 10.3% compared to 5.0% among nulliparous women in the general Norwegian population. Women who underwent deinfibulation during labor had a lower risk than women who underwent deinfibulation before labor (odds ratio 0.48, 95% confidence interval 0.27–0.86, P = 0.01). CONCLUSIONS: The high rate of anal sphincter injury in Somali nulliparous women was not related to type of female genital mutilation/cutting. Deinfibulation during labor protected against anal sphincter injury, whereas deinfibulation before labor was associated with a doubled risk. Deinfibulation before labor should not be routinely recommended during pregnancy.
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spelling pubmed-98121992023-01-05 Risk of obstetric anal sphincter injury associated with female genital mutilation/cutting and timing of deinfibulation Taraldsen, Sølvi Vangen, Siri Øian, Pål Sørbye, Ingvil K. Acta Obstet Gynecol Scand Birth INTRODUCTION: A greater risk of obstetric anal sphincter injury has been reported among African migrants in several host countries compared with the general population. To what degree female genital mutilation/cutting affects this risk is not clear. In infibulated women, deinfibulation prevents anal sphincter injury. Whether the timing of deinfibulation affects the risk, is unknown. This study aimed to investigate the risks of anal sphincter injury associated with female genital mutilation/cutting and timing of deinfibulation in Norway, and to compare the rates of anal sphincter injury in Somali‐born women and the general population. MATERIAL AND METHODS: In a historical cohort study, nulliparous Somali‐born women who had a vaginal birth in the period 1990–2014 were identified by the Medical Birth Registry of Norway and data collected from medical records. Exposures were female genital mutilation/cutting status and deinfibulation before labor, during labor or no deinfibulation. The main outcome was obstetric anal sphincter injuries. RESULTS: Rates of obstetric anal sphincter injury did not differ significantly by female genital mutilation/cutting status (type 1–2: 10.2%, type 3: 11.3%, none: 15.2% P = 0.17). The total rate of anal sphincter injury was 10.3% compared to 5.0% among nulliparous women in the general Norwegian population. Women who underwent deinfibulation during labor had a lower risk than women who underwent deinfibulation before labor (odds ratio 0.48, 95% confidence interval 0.27–0.86, P = 0.01). CONCLUSIONS: The high rate of anal sphincter injury in Somali nulliparous women was not related to type of female genital mutilation/cutting. Deinfibulation during labor protected against anal sphincter injury, whereas deinfibulation before labor was associated with a doubled risk. Deinfibulation before labor should not be routinely recommended during pregnancy. John Wiley and Sons Inc. 2022-08-09 /pmc/articles/PMC9812199/ /pubmed/35946127 http://dx.doi.org/10.1111/aogs.14424 Text en © 2022 The Authors. Acta Obstetricia et Gynecologica Scandinavica published by John Wiley & Sons Ltd on behalf of Nordic Federation of Societies of Obstetrics and Gynecology (NFOG). https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Birth
Taraldsen, Sølvi
Vangen, Siri
Øian, Pål
Sørbye, Ingvil K.
Risk of obstetric anal sphincter injury associated with female genital mutilation/cutting and timing of deinfibulation
title Risk of obstetric anal sphincter injury associated with female genital mutilation/cutting and timing of deinfibulation
title_full Risk of obstetric anal sphincter injury associated with female genital mutilation/cutting and timing of deinfibulation
title_fullStr Risk of obstetric anal sphincter injury associated with female genital mutilation/cutting and timing of deinfibulation
title_full_unstemmed Risk of obstetric anal sphincter injury associated with female genital mutilation/cutting and timing of deinfibulation
title_short Risk of obstetric anal sphincter injury associated with female genital mutilation/cutting and timing of deinfibulation
title_sort risk of obstetric anal sphincter injury associated with female genital mutilation/cutting and timing of deinfibulation
topic Birth
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9812199/
https://www.ncbi.nlm.nih.gov/pubmed/35946127
http://dx.doi.org/10.1111/aogs.14424
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