Clitoral sizes and anogenital distances in term newborns in Nigeria

Abstract

BackgroundPrevious studies suggest significant ethnic and racial differences in clitoral sizes and anogenital distances in the newborn. This study aimed to document normative data on clitoral sizes and anogenital distances of apparently normal term female infants in Sagamu.MethodsThe study was a multi-center, cross-sectional descriptive research carried out among 317 female term infants within the first 72 h of life. Interviewer-based questionnaire was applied to obtain sociodemographic data, pregnancy and birth history. A sliding digital caliper was used for measurement. Data analysis was with SPSS version 20.0.ResultsThe mean clitoral length was 6.7 ± 1.6 mm while the mean clitoral width was 5.6 ± 0.8 mm. The mean fourchette-clitoris distance, anus-clitoris distance and anus-fourchette distance were 21.9 ± 2.1 mm, 35.5 ± 2.5 mm and 17.0 ± 2.6 mm respectively. The anus-clitoris and anus-fourchette distances significantly correlated with the anthropometric parameters while the clitoral measurements did not.ConclusionThe mean values recorded in this study were higher than observed in most previous studies. This simple, affordable and non-invasive evaluation could aid early diagnosis and treatment of female infants with potentially harmful conditions such as congenital adrenal hyperplasia.

Comparative study of neonatal clitoral length measurement using calliper and spatula

“…If one of the parents did not belong to any ethnic group in Nigeria, such baby was also excluded. [6] For an adequate representation of the population, subjects were recruited from five health facilities from the two levels of healthcare (primary and tertiary) available in Sagamu. These included one teaching hospital, two specialist private hospitals and two primary health centres (PHC).…”

“…The standards of clitoral sizes in the newborn have been previously published using different measuring devices such as a phallometer, [4] bow compass calliper, [2] ruler, [5] and sliding digital calliper. [3,6,7] Perhaps, the most widely acceptable device for measurement is the digital calliper. Variation in the instruments used is likely to produce different values and make comparisons difficult.…”

“…Previous studies have shown that neonatal clitoral length appears longer in Nigerians than non-Nigerians despite the differences in the instruments used. [5,6] Regardless of the instrument used, clitoral length greater than 1 cm in the newborn is generally regarded as pathologic. [3] Although normative data, using a sliding digital calliper, were previously generated for the location of the present study, [6] most births in developing countries take place outside specialist facilities, [7] where sliding callipers may not be available.…”

“…[5,6] Regardless of the instrument used, clitoral length greater than 1 cm in the newborn is generally regarded as pathologic. [3] Although normative data, using a sliding digital calliper, were previously generated for the location of the present study, [6] most births in developing countries take place outside specialist facilities, [7] where sliding callipers may not be available. Furthermore, the measurement of clitoral length at birth may facilitate early diagnosis of congenital adrenal hyperplasia, which may be life-threatening in the salt-wasting type.…”

Nonvirilized Genitalia in 3 Female Newborns With the Salt-Wasting Congenital Adrenal Hyperplasia Phenotype

“…Further measurements revealed that the clitoral length was 1 cm, clitoral width was 0.8 cm, anus-fourchette distance was 2.1 cm and anus-clitoris distance was 4 cm. The anogenital ratio (anus-fourchette distance/anus-clitoris distance) was 0.525, suggesting possible mild posterior labial fusion because of the greater than 0.5 value [ 7 ]. Pelvic ultrasound demonstrated a uterus but ovaries were not visualized.…”