Female Genital Mutilation and Obstetric Outcomes: Flawed Systematic Review and Meta-Analysis Does Not Accurately Reflect the Available Evidence

Table 1

Relative risk (RR) estimates (95% confidence limits) for health outcomes in a data set on obstetric outcome of delivery by FGM status and method of analysis. Adjusted RRs from WHO/HRP 2006 and unadjusted RRs from Berg and Underland 2013.

Health outcomes and comparison groups	WHO/HRP original published results (adjusted^1 RR (95% CI) by type of FGM and parity) [3]	WHO/HRP results presented by Berg and Underland (unadjusted RR (95% CI), all types of FGM) [1, 2]
Perineal tear	Primiparous women^2	All women; 0.90 (0.82–1.00)
FGM I versus no FGM	1.31 (1.03–1.66)
FGM II versus no FGM	1.92 (1.50–2.47)
FGM III versus no FGM	3.19 (1.91–4.74)
	Multiparous women^2
FGM I versus no FGM	1.37 (1.07–1.75)
FGM II versus no FGM	2.17 (1.69–2.82)
FGM III versus no FGM	1.93 (1.07–3.38)
Episiotomy	Primiparous women^3	All women; 1.57 (1.51–1.63)
FGM I versus no FGM	1.31 (1.20–1.44)
FGM II versus no FGM	1.47 (1.34–1.60)
FGM III versus no FGM	1.84 (1.70–1.97)
	Multiparous women^3
FGM I versus no FGM	1.75 (1.47–2.09)
FGM II versus no FGM	2.02 (1.69–2.42)
FGM III versus no FGM	2.16 (1.91–2.44)
Caesarean section	All women	All women; 0.83 (0.75–0.91)
FGM I versus no FGM	1.03 (0.88–1.21)
FGM II versus no FGM	1.29 (1.09–1.52)
FGM III versus no FGM	1.31 (1.01–1.70)
Postpartum haemorrhage	All women	All women; 1.23 (1.11–1.36)
FGM I versus no FGM	1.03 (0.87–1.21)
FGM II versus no FGM	1.21 (1.01–1.43)
FGM III versus no FGM	1.69 (1.34–2.12)

1Adjusted for study centre, maternal age, parity, maternal height, maternal education, socioeconomic status, residence (urban or rural), time taken to reach hospital, and number of antenatal care visits. ²Women without episiotomy. ³Women with or without a perineal tear.