Trend in female genital mutilation and its associated adverse birth outcomes: A 10-year retrospective birth registry study in Northern Tanzania

Approximately 200 million women and girls were reported to have undergone female genital mutilation worldwide in 2015.UNICEF's data based on household survey estimates 15% of women from 15-49 years have undergone FGM from year 2004-2015. Despite this, reliable data on trend of prevalence of fem...

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Published in:	PloS one Vol. 16; no. 1; p. e0244888
Main Authors:	Suleiman, Issa Rashid, Maro, Eusebious, Shayo, Benjamin C, Alloyce, Julius Pius, Masenga, Gileard, Mahande, Michael J, Mchome, Bariki
Format:	Journal Article
Language:	English
Published:	United States Public Library of Science 06-01-2021 Public Library of Science (PLoS)
Subjects:	Adult Age Apgar score Birth Circumcision, Female - adverse effects Circumcision, Female - trends Clitoris Confidence intervals Cross-Sectional Studies Diabetes Female Female circumcision Females Forecasts and trends Genital mutilation Gynecology Hemorrhage Humans Infant, Newborn Medicine and Health Sciences Midwifery Mothers Neonates Obstetrics People and Places Postpartum Pregnancy Pregnancy Outcome - epidemiology Pregnancy, Complications of Regression models Retrospective Studies Risk factors Social Sciences Sociodemographics Statistical analysis Tanzania Vagina Women Womens health Tanzania Africa
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Summary:	Approximately 200 million women and girls were reported to have undergone female genital mutilation worldwide in 2015.UNICEF's data based on household survey estimates 15% of women from 15-49 years have undergone FGM from year 2004-2015. Despite this, reliable data on trend of prevalence of female genital mutilation and its associated birth outcomes have not been documented in Tanzania. This study aimed at determining the trends of female genital mutilation and associated maternal and neonatal adverse outcomes in northern Tanzania. A cross-sectional study was conducted using maternally-linked data from Kilimanjaro Christian Medical birth registry involving 30,286 women who gave birth to singletons from 2004-2014. The prevalence of female genital mutilation was computed as proportion of women with female genital mutilation yearly over 10 years. Odds ratios with 95% confidence intervals for adverse birth outcomes associated with female genital mutilation were estimated using multivariable logistic regression model. Over the 10-year period, the prevalence of female genital mutilation averaged 15.4%. Female genital mutilation decreased from 23.6% in 2005 to 10.6% in 2014. Female genital mutilation was associated with increased odds for caesarean section (aOR1.26; 95% CI: 1.18-1.34), post-partum haemorrhage (aOR 1.31; 95% CI: 1.10-1.57) and long hospital stay (aOR 1.21; 95% CI: 1.14-1.29). Female genital mutilation also increased women's likelihood of delivering an infant with low Apgar score at 5th minute (aOR 1.60; 95% CI: 1.37-1.89).FGM type III and IV had increased odds of caesarean section, episiotomy and prolonged duration of hospital stay as compared to FGM type I and II, although the association was statistically insignificant. Female genital mutilation prevalence has declined over the study period. Our study has demonstrated that postpartum haemorrhage, delivery by caesarean section, long maternal hospital stays and low APGAR score are associated with FGM. Initiatives to mitigate FGM practice should be strengthened further to reduce/eliminate this practice. Moreover, surgical interventions to improve severe form FGM are welcomed to improve the aforementioned aspects of obstetric outcome in this locality.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Competing Interests: There are no competing interests to declare by all authors.
ISSN:	1932-6203 1932-6203
DOI:	10.1371/journal.pone.0244888