Perinatal complications among ethnic Somalis in Norway

Background. The majority of ethnic Somali women in Norway have undergone an elaborate form of circumcision (infibulation). The aim of this study was to examine the risk of perinatal complications among ethnic Somalis and to discuss its relation to circumcision. Methods. We conducted a cross-sectional population-based registry study. Data on all births to women born in Somalia (1733) and Norway (702192) from 1986 to 1998 was provided from the Medical Birth Registry of Norway We analyzed the risk of perinatal complications among women of Somali origin vs. ethnic Norwegians using univariate and multivariate methods. Results. Perinatal complications were more frequent among women of Somali origin than among ethnic Norwegians. These included induction of labor, fetal distress, secondary arrest, prolonged second stage of labor, operative delivery and perinatal death. Particularly elevated odds ratios were found for fetal distress (odds ratio=2.6, 95% confidence interval (0); 2.2-3.0), emergency cesarean sections (odds ratio=3.0, 95% confidence interval 2.6-3.4), Apgar scores below seven (odds ratio =3.1, 95% confidence interval 2.4-4.0) and prelabor fetal deaths (odds ratio=2.5, 95% confidence interval 1.7-3.7). Conclusion. Similar findings in infibulated vs. noncircumcised women have been demonstrated previously in other studies indicating that circumcision could play a role. The current study is the first to be conducted among Somali women in Europe. However, the results are not informative on whether the adverse birth outcomes are caused by infibulation as such or in combination with suboptimal perinatal care, intercurrent diseases and sociocultural factors. Somali women represent a high-risk group in obstetrics, calling for special attention and care.