{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T18:44:55Z","timestamp":1792176295050,"version":"4.4.0"},"reference-count":33,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T00:00:00Z","timestamp":1779926400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T00:00:00Z","timestamp":1779926400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study identifies factors associated with not proceeding to clitoral reconstructive surgery among women with female genital mutilation (FGM) enrolled in a specialized surgical pathway.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective cohort study was conducted at a multidisciplinary referral center in Montreuil, France, between January 2021 and December 2023. The study included 220 women who expressed a wish for reconstructive surgery during their initial assessment. Factors associated with non\u2010progression to surgery were identified using univariable and multivariable logistic regression, supplemented by Bayesian analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of the 220 women, 35% did not proceed to surgery. In the multivariable model, lack of support within the care pathway (odds ratio [OR] 3.28, 95% confidence interval [CI] 1.46\u20137.55;\n                      <jats:italic>P\u2009=<\/jats:italic>\n                      \u20090.004) and financial vulnerability, specifically reliance on state welfare (OR 3.43, 95% CI 1.28\u20139.80;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.017) or financial support from relatives\/community (OR 6.18, 95% CI 1.40\u201328.9;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.017), were independently associated with non\u2010progression. Model discrimination was good (area under the curve 0.75). Bayesian analysis confirmed these findings (\n                      <jats:italic>P<\/jats:italic>\n                      [direction] &gt;99%) and suggested that memory of the FGM event also played a role (OR 1.87, 95% credible interval 0.88\u20134.09;\n                      <jats:italic>P<\/jats:italic>\n                      [direction] 94.9%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Access to clitoral reconstruction is primarily determined by socioeconomic stability and social support rather than clinical factors alone. These findings highlight the need for multidisciplinary pathways that integrate social and psychological accompaniment to ensure equitable access to care for vulnerable women.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ijgo.71094","type":"journal-article","created":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T12:20:20Z","timestamp":1779970820000},"page":"846-856","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Risk factors for not proceeding to reconstructive surgery after female genital mutilation: A cohort study of 220 women in a specialized referral center"],"prefix":"10.1002","volume":"175","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-4841-2770","authenticated-orcid":false,"given":"F\u00e9licia","family":"Joinau\u2010Zoulovits","sequence":"first","affiliation":[{"name":"Universit\u00e9 Paris Cit\u00e9 and Universit\u00e9 Sorbonne Paris Nord, Inserm, INRAE, Centre for Research in Epidemiology and Statistics, Obstetric Perinatal and Paediatric Life Course Epidemiology Team OPPaLE, iWISH  Paris France"},{"name":"Maternity Unit, AP\u2010HP Bichat Hospital  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ma\u00eblle Silvestre","family":"De Sacy","sequence":"additional","affiliation":[{"name":"Maternity Unit Centre Hospitalier Andr\u00e9 Gr\u00e9goire  Montreuil France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno","family":"Renevier","sequence":"additional","affiliation":[{"name":"Maternity Unit Centre Hospitalier Andr\u00e9 Gr\u00e9goire  Montreuil France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Abramowicz","sequence":"additional","affiliation":[{"name":"Maternity Unit Centre Hospitalier Andr\u00e9 Gr\u00e9goire  Montreuil France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,28]]},"reference":[{"key":"e_1_2_14_2_1","volume-title":"WHO Guideline on the Prevention of Female Genital Mutilation and Clinical Management of Complications","author":"World Health Organization","year":"2025"},{"key":"e_1_2_14_3_1","volume-title":"Eliminating female genital mutilation: an interagency statement\u2014OHCHR, UNAIDS, UNDP, UNECA, UNESCO, UNFPA, UNHCR, UNICEF, UNIFEM, WHO","author":"World Health Organisation","year":"2008"},{"key":"e_1_2_14_4_1","doi-asserted-by":"publisher","DOI":"10.1080\/01674820802547087"},{"key":"e_1_2_14_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jflm.2023.102624"},{"key":"e_1_2_14_6_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-3156.2001.00749.x"},{"key":"e_1_2_14_7_1","volume-title":"Gynecological Consequences of Female Genital Mutilation\/Cutting (FGM\/C)","author":"Berg RC","year":"2014"},{"key":"e_1_2_14_8_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.162.5.1000"},{"key":"e_1_2_14_9_1","volume-title":"Psychological, Social and Sexual Consequences of Female Genital Mutilation\/Cutting (FGM\/C): A Systematic Review of Quantitative Studies","author":"Berg RC","year":"2010"},{"key":"e_1_2_14_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(06)68805-3"},{"key":"e_1_2_14_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jgyn.2015.01.008"},{"key":"e_1_2_14_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gyobfe.2015.09.002"},{"key":"e_1_2_14_13_1","first-page":"392","article-title":"Estimation du nombre de femmes adultes ayant subi une mutilation g\u00e9nitale f\u00e9minine vivant en France","volume":"21","author":"Lesclingand M","year":"2019","journal-title":"Bull Epidemiol Hebd"},{"key":"e_1_2_14_14_1","first-page":"47","article-title":"Reconstructive plastic surgery of the clitoris after sexual mutilation","volume":"14","author":"Foldes P","year":"2004","journal-title":"Prog Urol"},{"key":"e_1_2_14_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jgyn.2015.02.013"},{"key":"e_1_2_14_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)60400-0"},{"key":"e_1_2_14_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2014.11.008"},{"key":"e_1_2_14_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gyobfe.2006.09.026"},{"key":"e_1_2_14_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jgyn.2016.03.010"},{"key":"e_1_2_14_20_1","unstructured":"LesclingandM SyllaF AndroA BoissonS.Projet MSF\u2010PREVAL. 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