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\begin{document}

\title{Effects of clitoral reconstruction for female genital mutilation on
perinatal outcomes: a retrospective case-control study}



\author[1]{Sebastien Madzou}%
\author[1]{Chloe Reau-Guisti}%
\author[1]{Soazig Herve}%
\author[2]{Katherine Zhu}%
\author[3]{Charlemagne Ouédrago}%
\author[1]{Caroline Verhaeghe}%
\author[1]{Philippe  Gillard}%
\author[1]{Laurent Catala}%
\author[1]{Vanessa Combaud}%
\author[4]{Philippe Descamps}%
\author[1]{Guillaume Legendre}%
\author[1]{Romain Corroenne}%
\affil[1]{CHU Angers}%
\affil[2]{Baylor College of Medicine}%
\affil[3]{Bogodo OUagadougou University Hospital}%
\affil[4]{CHU}%


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  \date{June 13, 2024}


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\begin{abstract}
Objectives: To investigate the perinatal outcomes of women with a
history of female genital mutilation (FGM) who underwent clitoral
reconstruction (CR) compared with women with FGM who did not undergo CR.
Design: Retrospective case-control study Setting: Angers University
Hospital, between 2005 and 2017 Methods: Inclusion criteria: pregnant
women \textgreater{}18 years who underwent CR after FGM. Only the first
subsequent delivery after CR was included. Each woman with CR was
matched for age, ethnicity, FGM type, parity, and gestational age at the
time of delivery with two women with FGM who did not undergo CR during
the same period of time. Main outcome measures: at birth: need for
episiotomy and intact perineum Results: 84 women were included (28 in
the CR group; 56 in the control group). In the CR group, patients
required significantly fewer episiotomies (5/17{[}29.4\%{]}) compared to
the control group (28/44{[}63.6\%{]}, p=0.02), even after excluding
operative vaginal deliveries (2/13{[}15.4\%{]} vs 21/36{[}58.3{]},
p\textless{}0.01). CR reduces the risk of episiotomy (aOR=0.15, 95\%CI
{[}0.04-0.56{]}; p\textless{}0.01) after adjusting on the infant weight
and the need for instrumental delivery. In the CR group, 47\% of the
patients had an intact perineum after delivery, compared to 20.4\% in
the control group (p=0.04). CR increases the odds of having an intact
perineum at birth by 3.46 times (CI95\%{[}1.04-11.49{]}; p=0.04).
Conclusion: CR after FGM increases the chances of having an intact
perineum after delivery by 3.46 times and reduces the risk of episiotomy
by 0.15 times compared to women with FGM who did not underwent CR.%
\end{abstract}%



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\textbf{Hosted file}

\verb`BJOG_FGM_manuscript.doc`  available at \url{https://authorea.com/users/324908/articles/452985-effects-of-clitoral-reconstruction-for-female-genital-mutilation-on-perinatal-outcomes-a-retrospective-case-control-study}

\textbf{Hosted file}

\verb`FGM_table1.docx`  available at \url{https://authorea.com/users/324908/articles/452985-effects-of-clitoral-reconstruction-for-female-genital-mutilation-on-perinatal-outcomes-a-retrospective-case-control-study}

\textbf{Hosted file}

\verb`FGM_table2.docx`  available at \url{https://authorea.com/users/324908/articles/452985-effects-of-clitoral-reconstruction-for-female-genital-mutilation-on-perinatal-outcomes-a-retrospective-case-control-study}

\textbf{Hosted file}

\verb`FGM_table3.docx`  available at \url{https://authorea.com/users/324908/articles/452985-effects-of-clitoral-reconstruction-for-female-genital-mutilation-on-perinatal-outcomes-a-retrospective-case-control-study}

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