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      Health Consequences of the Female Genital Mutilation: A Systematic Review

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          Abstract

          Female genital mutilation (FGM) is a general health concern. The World Health Organization has recognized it as a condition that endangers women’s health. This review study aimed to identify the types of health outcomes of FGM. Therefore, a systematic review was conducted to create a critical view of the current evidence on the effect of Female genital on girls and women’s health. In this study, we focused on the health risks of female Female genital. Academic databases such as PubMed, Science Direct, Scopus, Google Scholar, Cochrane Database of Systematic Reviews, SID, IranMedex, Irandoc, and Magiran were searched with regard to the health consequences of FGM from January 1990 until 2018. Eleven review studies met the criteria and contained 288 relevant studies on the risks of FGM. It was suggested that FGM had various physical, obstetric, sexual, and psychological consequences. Women with FGM experienced mental disturbances (e.g., psychiatric diagnoses, anxiety, somatization, phobia, and low self-esteem) than other women. Our study can provide evidence on improving, changing behaviors, and making decisions on the quality of services offered to women suffering from FGM.

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          Female genital mutilation and obstetric outcome: WHO collaborative prospective study in six African countries.

          Emily Banks, Olav Meirik, Tim Farley … (2006)
          Reliable evidence about the effect of female genital mutilation (FGM) on obstetric outcome is scarce. This study examines the effect of different types of FGM on obstetric outcome. 28 393 women attending for singleton delivery between November, 2001, and March, 2003, at 28 obstetric centres in Burkina Faso, Ghana, Kenya, Nigeria, Senegal, and Sudan were examined before delivery to ascertain whether or not they had undergone FGM, and were classified according to the WHO system: FGM I, removal of the prepuce or clitoris, or both; FGM II, removal of clitoris and labia minora; and FGM III, removal of part or all of the external genitalia with stitching or narrowing of the vaginal opening. Prospective information on demographic, health, and reproductive factors was gathered. Participants and their infants were followed up until maternal discharge from hospital. Compared with women without FGM, the adjusted relative risks of certain obstetric complications were, in women with FGM I, II, and III, respectively: caesarean section 1.03 (95% CI 0.88-1.21), 1.29 (1.09-1.52), 1.31 (1.01-1.70); postpartum haemorrhage 1.03 (0.87-1.21), 1.21 (1.01-1.43), 1.69 (1.34-2.12); extended maternal hospital stay 1.15 (0.97-1.35), 1.51 (1.29-1.76), 1.98 (1.54-2.54); infant resuscitation 1.11 (0.95-1.28), 1.28 (1.10-1.49), 1.66 (1.31-2.10), stillbirth or early neonatal death 1.15 (0.94-1.41), 1.32 (1.08-1.62), 1.55 (1.12-2.16), and low birthweight 0.94 (0.82-1.07), 1.03 (0.89-1.18), 0.91 (0.74-1.11). Parity did not significantly affect these relative risks. FGM is estimated to lead to an extra one to two perinatal deaths per 100 deliveries. Women with FGM are significantly more likely than those without FGM to have adverse obstetric outcomes. Risks seem to be greater with more extensive FGM.
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            Effects of female genital cutting on physical health outcomes: a systematic review and meta-analysis

            Rigmor Berg, Vigdis Underland, Jan Odgaard-Jensen … (2014)
            Objective Worldwide, an estimated 125 million girls and women live with female genital mutilation/cutting (FGM/C). We aimed to systematically review the evidence for physical health risks associated with FGM/C. Design We searched 15 databases to identify studies (up to January 2012). Selection criteria were empirical studies reporting physical health outcomes from FGM/C, affecting females with any type of FGM/C, irrespective of ethnicity, nationality and age. Two review authors independently screened titles and abstracts, applied eligibility criteria, assessed methodological study quality and extracted full-text data. To derive overall risk estimates, we combined data from included studies using the Mantel-Haenszel method for unadjusted dichotomous data and the generic inverse-variance method for adjusted data. Outcomes that were sufficiently similar across studies and reasonably resistant to biases were aggregated in meta-analyses. We applied the instrument Grading of Recommendations Assessment, Development and Evaluation to assess the extent to which we have confidence in the effect estimates. Results Our search returned 5109 results, of which 185 studies (3.17 million women) satisfied the inclusion criteria. The risks of systematic and random errors were variable and we focused on key outcomes from the 57 studies with the best available evidence. The most common immediate complications were excessive bleeding, urine retention and genital tissue swelling. The most valid and statistically significant associations for the physical health sequelae of FGM/C were seen on urinary tract infections (unadjusted RR=3.01), bacterial vaginosis (adjusted OR (AOR)=1.68), dyspareunia (RR=1.53), prolonged labour (AOR=1.49), caesarean section (AOR=1.60), and difficult delivery (AOR=1.88). Conclusions While the precise estimation of the frequency and risk of immediate, gynaecological, sexual and obstetric complications is not possible, the results weigh against the continuation of FGM/C and support the diagnosis and management of girls and women suffering the physical risks of FGM/C. Trial registration number This study is registered with PROSPERO, number CRD42012003321.
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              The consequences of female circumcision for health and sexuality: an update on the evidence.

              Carla Obermeyer (2015)
              This systematic review of published sources between 1997 and 2005 shows that female circumcision is associated with some health consequences but that no statistically significant associations are documented for a number of health conditions. This is in part a result of the difficulty of designing studies on the more extensive operations (infibulation). The findings of the analysis can be summarized as follows: statistically higher risks are documented for some but not all types of infections; the evidence regarding urinary symptoms is inconclusive; the evidence on obstetric and gynecological complications is mixed: increased risks have been reported for some complications of labour and delivery but not others, and for some symptoms such as abdominal pain and discharge, but not others such as infertility or increased mortality of mother or infant. Concerning sexuality, most of the existing studies suffer from conceptual and methodological shortcomings, and the available evidence does not support the hypotheses that circumcision destroys sexual function or precludes enjoyment of sexual relations. This review highlights the difficulties of research on the health and sexuality consequences of FGC, underscores the importance of distinguishing between more and less extensive operations, and emphasizes the need to go beyond simple inventories of physical harm or frequencies of sexual acts.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Galen Med J
                Journal ID (iso-abbrev): Galen Med J
                Journal ID (publisher-id): Galen Medical Journal
                Journal ID (pmc): Galen Medical Journal
                Journal ID (publisher-id): gmj
                Title: Galen Medical Journal
                Publisher: Salvia Medical Sciences Ltd
                ISSN (Print): 2588-2767
                ISSN (Electronic): 2322-2379
                Publication date Collection: 2019
                Publication date (Electronic): 1 January 2019
                Volume: 8
                Page: e1336
                Affiliations
                1Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
                2Nursing and Midwifery Care Research Centre, Mashhad University of Medical Sciences, Mashhad, Iran
                3College of Food, Agricultural, and Environmental Sciences, Program Development & Evaluation, Ohio State University, Columbus, Ohio Area, United States
                Author notes
                [* ] Correspondence to: Robab Latifnejad Roudsari, Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Ebn-e Sina St., Mashhad, Iran Telephone Number: 051-38598016 Email Address: Saraylouk931@ 123456mums.ac.ir
                Article
                DOI: 10.22086/gmj.v8i0.1336
                PMC ID: 8343977
                PubMed ID: 34466496
                SO-VID: 4beb41b2-c5d7-4f25-a277-3260d8e2f84b
                Copyright © Copyright© 2019, Galen Medical Journal.
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/)

                History
                Date received : 18 September 2018
                Date revision received : 17 October 2018
                Date accepted : 18 November 2018
                Page count
                Figures: 1, Tables: 4, References: 20, Pages: 19
                Categories
                Subject: Review Article

                Keywords: female genital,female,obstetric labor complications,pregnancy complications,emotional aspects
                Data availability:
                Keywords: female genital, female, obstetric labor complications, pregnancy complications, emotional aspects

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