Are some perinatal deaths in immigrant groups linked to suboptimal perinatal care services?

No association between female circumcision and prolonged labour: a case control study of immigrant women giving birth in Sweden

OBJECTIVE

Several authors' associate female genital circumcision with obstructed and prolonged labour, but the World Health Organization recently stated that no scientific evidence confirms such a relationship. The object of this study was to compare the duration of the second stage of labour between circumcised and non-circumcised women in a high-income community in Europe.

METHODS

Sixty-eight circumcised nulliparous women originally from the Horn of Africa were compared to a group of 2486 non-circumcised nulliparous who gave birth at a university hospital setting in Sweden, 1990-1996. Defibulation was routinely performed during labour.

FINDINGS

Circumcised women were found to have had second stage labour, which was significantly statistically shorter (35/53 min, respectively, p < or = 0.001) and a lower risk of prolonged labour than the non-circumcised group.

CONCLUSIONS

Prolonged labour does not seem to be associated to female genital circumcision in affluent societies with high standards of obstetric care.

Female genital mutilation in the West: traditional circumcision versus genital cosmetic surgery

This article intends to present the Scandinavian legislation on female genital mutilation and explore the implications of the laws. Juxtaposing trends of plastic genital surgery in the West with claims that female circumcision may be a practice generally abandoned in Scandinavia, we highlight the double morality inherent in current public discussions. Finally, we pose the question: Is the legal principle of equality before the law regarded when it comes to alterations of the female genitals?

Preterm birth and maternal country of birth in a French district with a multiethnic population

OBJECTIVES

This analysis explores the association between preterm birth and maternal country of birth in a French district with a multiethnic population.

DESIGN

Prospective observational study.

SETTING

District of Seine-Saint-Denis in France

POPULATION

48,746 singleton live births from a population-based birth register between October 1998 and December 2000.

METHODS

We compare preterm birth rates by mother's country of birth controlling for demographic and obstetric factors as well as insurance coverage and timing of initiation of antenatal care.

MAIN OUTCOME MEASURES

Overall preterm birth rates and preterm birth rates by timing of delivery (<33 weeks versus 33-36 weeks of gestation), mode of onset (spontaneous or indicated preterm birth) and the presence of hypertension in pregnancy.

RESULTS

Women born in Northern Africa, Southern Europe and South/East Asia did not have higher preterm birth rates than women born in continental France. Rates were significantly higher for women born in the overseas French districts in the Caribbean and Indian Ocean and Sub-Saharan Africa. Excess risk was greatest for early preterm births, medically indicated births and preterm births associated with hypertension.

CONCLUSIONS

Patterns of preterm birth with relation to timing, mode of onset and medical complications among of Afro-Caribbean origin should be confirmed in future research.