Aims Prevalence of Female Genital Mutilation/Cutting (FGM/C) among women in The Gambia is 76.3%. FGM/C was banned in 2015, but there is fear that it may be driven underground. This study aimed to provide national data on healthcare outcomes (previously lacking) to support advocacy and health education.
Methods A multicentre prospective observational study carried out across 4 healthcare facilities in the Gambia between May and September 2016. Inclusion criteria: Consenting women aged 18 and over presenting in early labour (singleton foetus) with or without FGM/C Data collection: Demographics, type of FGM/C (WHO classification) and outcomes of labour. Neonatal outcomes: Perinatal death, neonatal resuscitation, low-birth-weight (table 1 and 2).
Results 1569 women were recruited. Mean age was 26.5 and parity 2.1. 77% had FGM/C. Abstract G261 Table 1 Risk of perinatal death FGM/C Cases/population Percentage Adjusted relative risk (95% CI ) * None 7/361 1.9 1.0 Type I 13/372 3.5 1.9 (0.7-4.6) Type II 33/704 4.7 2.5 (1.1-5.7) Type III/IV 3/132 2.3 1.3 (0.3-5.1) *p=0.11 Abstract G261 Table 2 Need for neonatal resuscitation FGM/C Cases/population Percentage Adjusted relative risk (95% CI )* None 31/361 8.6 1.0 Type I 50/372 13.4 1.9 (1.2-3.2) Type II 121/704 17.2 2.5 (1.6-4.0) Type III/IV 38/132 28.8 3.9 (2.4-6.5) *p<0.001 There was no association between FGM/C and low-birth-weight babies observed in this study.
Conclusion A statistically significant increased risk of perinatal death was observed with type II FGM/C. The study may be underpowered to demonstrate increased risk across all types of FGM/C. Increased risk of need for neonatal resuscitation was observed in all forms of FGM/C. These results are in keeping with those from other African countries and, it is hoped, will be useful in the advocacy and sensitisation needed to end this practice