Clitoral length and anogenital ratio in Indian newborn girls

Mondal, Rakesh; Chatterjee, Kaushani; Samanta, Moumita; Hazra, Avijit; Ray, Santanu; Sabui, Tapas; Banerjee, Basanta; Das, Suman; Roychowdhury, Dibyendu; Biswas, Rupa

doi:10.1007/s13312-016-0840-1

Cited by 18 publications

(19 citation statements)

References 12 publications

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“…A shorter AGDas and penile length have been found in infants with hypospadias and cryptorchidism, a longer AGDaf has been described in female infants with androgen excess, for example, in congenital adrenal hyperplasia (CAH). In typical female infants, it was shown that calculating the anogenital-ratio (AGDaf:AGDac) offers advantages as it follows a normal distribution and does not correlate with anthropometric variables or gestational age (19,20). The Prader score (PS) was developed by Andrea Prader in 1954 to capture genital variation in children who have CAH.…”

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confidence: 99%

The External Genitalia Score (EGS): A European Multicenter Validation Study

Straaten

Springer

Zecic

et al. 2019

The Journal of Clinical Endocrinology &Amp; Metabolism

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Context Standardized description of external genitalia is needed in the assessment of children with atypical genitalia. Objectives To validate the External Genitalia Score (EGS), to present reference values for preterm and term babies up to 24 months and correlate obtained scores with anogenital distances (AGDs). Design, Setting A European multicenter (n = 8) validation study was conducted from July 2016 to July 2018. Patients and Methods EGS is based on the external masculinization score but uses a gradual scale from female to male (range, 0–12) and terminology appropriate for both sexes. The reliability of EGS and AGDs was determined by the interclass correlation coefficient (ICC). Cross-sectional data were obtained in 686 term babies (0–24 months) and 181 preterm babies, and 111 babies with atypical genitalia. Results The ICC of EGS in typical and atypical genitalia is excellent and good, respectively. Median EGS (10th to 90th centile) in males < 28 weeks gestation is 10 (8.6–11.5); in males 28–32 weeks 11.5 (9.2–12); in males 33–36 weeks 11.5 (10.5–12) and in full-term males 12 (10.5–12). In all female babies, EGS is 0 (0-0). The mean (SD) lower/upper AGD ratio (AGDl/u) is 0.45 (0.1), with significant difference between AGDl/u in males 0.49 (0.1) and females 0.39 (0.1) and intermediate values in differences of sex development (DSDs) 0.43 (0.1). The AGDl/u correlates with EGS in males with typical genitalia and in atypical genitalia. Conclusions EGS is a reliable and valid tool to describe external genitalia in premature and term babies up to 24 months. EGS correlates with AGDl/u in males. It facilitates standardized assessment, clinical decision-making and multicenter research.

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confidence: 99%

The External Genitalia Score (EGS): A European Multicenter Validation Study

Straaten

Springer

Zecic

et al. 2019

The Journal of Clinical Endocrinology &Amp; Metabolism

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“…Our MCL was also similar to that of other studies that involved preterms, including the 3.66 ± 0.13 mm reported by Riley and Rosenbloom [13] in black term and preterm newborns in United States. Mondal et al [20] also reported a comparable albeit slightly lower MCL of 3.1 ± 1.54 mm in India and Jarrett et al [19] reported a relatively higher MCL of 7.7 ± 1.37 mm in 244 term and preterm newborns in Nigeria.…”

Section: Discussionmentioning

confidence: 97%

“…Some studies included preterms [13, 19, 20] whereas this study recruited only term newborns. Clitoral size has also been reported to correlate with anthropometric parameters of the study population [10].…”

Section: Discussionmentioning

confidence: 99%

Clitoral size in term newborns in Kumasi, Ghana

Asafo-Agyei

Ameyaw

Chanoine

et al. 2017

Int J Pediatr Endocrinol

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BackgroundData on normative clitoral sizes in newborns is relatively sparse and racial/ethnic differences have also been reported. This study was performed to establish norms for clitoral size in term Ghanaian female newborns.MethodsThis was a cross-sectional study of all apparently well full-term newborns of postnatal age < 48 h and birth weight between 2.5 and 4.0 kg delivered at Komfo Anokye Teaching Hospital between May and September, 2014. Anthropometric and genital parameters were documented for study subjects as well as parental socio-demographic indices.ResultsIn 612 newborn females studied, the mean (±SD) clitoral length (MCL) and the mean (±SD) clitoral width (MCW) were 4.13 ± 1.6 mm and 4.21 ± 1.1 mm, respectively. MCL was inversely related to birth weight (r = −0.62; p < 0.001) while MCW was inversely related to both gestational age (r = −0.1; p = 0.02) and birth weight (r = −0.54; p < 0.001). Babies with a clitoris that was completely covered by the labia majora had relatively lower clitoral sizes (p < 0.001) than those who had a partially covered or prominent clitoris. Neither MCL nor MCW differed significantly by birth length or maternal tribe.ConclusionsClitoral size varies with birth weight and gestational age. Babies with a completely covered clitoris are unlikely to warrant detailed clitoral measurements for clitoromegaly.

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“…As far as the authors are concerned, the present study is the first to investigate the clitoral size in newborn females in Iran, and very few similar studies in Middle East has been undertaken. Normative clitoral size data for healthy term newborns have been reported sparsely from different Asian and Caucasian infants (12)(13)(14)(15)(16). Also, only few studies are available, conducted on both term and preterm infants (12,16).…”

Section: Introductionmentioning

confidence: 99%

“…Normative clitoral size data for healthy term newborns have been reported sparsely from different Asian and Caucasian infants (12)(13)(14)(15)(16). Also, only few studies are available, conducted on both term and preterm infants (12,16). Thus, this study was performed to establish mean and standard deviation (SD) values of CL and CW of Iranian term and preterm newborns in relation to gestational age (GA) and anthropometric measurements.…”

Section: Introductionmentioning

confidence: 99%

The Nomogram of Clitoral Length and Width in Iranian Term and Preterm Neonates

et al. 2020

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Background and Objectives: Clitoromegaly is an important parameter in the evaluation of ambiguous genitalia in neonates, but the normative data for clitoral size in newborns have racial/ethnic differences. The present study aimed to determine clitoral length (CL) and clitoral width (CW) values and establish cutoff measurement to define clitoromegaly in both term and preterm Iranian neonates for the first time. Conclusion: This study suggests normative values (mean + 1, 2, and 3 SD) of CL and CW according to GA, which can be used as a reference for Middle East's newborns, especially Iranian newborn babies.

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Clitoral length and anogenital ratio in Indian newborn girls

Abstract: The normative values generated can serve as reference standard in the assessment of clitoromegaly, ambiguous genitalia, virilizing effects and suspected in utero androgen exposure.

Cited by 18 publications

References 12 publications

The External Genitalia Score (EGS): A European Multicenter Validation Study

The External Genitalia Score (EGS): A European Multicenter Validation Study

Clitoral size in term newborns in Kumasi, Ghana

The Nomogram of Clitoral Length and Width in Iranian Term and Preterm Neonates

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