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Estimation of Reference Values for External Genitalia Parameters in North Indian Preterm and Term Female Newborns

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Abstract

Objectives

To establish gestation-wise normative data of external genitalia measurements in North Indian term and preterm female newborns.

Methods

In this cross-sectional descriptive study, institutionally-born female neonates between 28-42 wk gestation were consecutively enrolled between 24-72 h of life. Newborns with major congenital malformations, chromosomal anomalies, multifetal gestation and birth injuries were excluded. Data on various genital measurements were collected [Clitoral length (CL), clitoral width (CW), ano-clitoral distance (AGDAC), ano-fourchette distance (AGDAF) and anogenital ratio (AGR)].

Results

One hundred ninety-eight of 508 neonates (39%) were preterm and 310 (61%) were term. Mean (± SD) CL and CW were 4.6 ± 1.8 mm and 3.9 ± 1.6 mm, respectively. Mean (± SD) values for AGDAF, AGDAC and AGR were 9.3 ± 1.8 mm, 30.2 ± 3.9 mm, and 0.31 ± 0.05, respectively. According to these results, term female newborns with CL more than 7 mm and/or CW more than 6 mm (95th centile) warrant evaluation for clitoromegaly. An anogenital ratio greater than 0.45 should be considered as a sign of virilization in a female neonate. Gestation-wise percentile charts for CL, CW, AGDAF, AGDAC and AGR were generated.

Conclusions

The percentile values defined in the study can serve as local normative data for accurate interpretation of genital measurements in North Indian female newborns and enable health care professionals for early identification of genital virilization.

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Author information

Authors and Affiliations

  1. Pediatric Endocrinology and Diabetes Unit, Department of Pediatrics, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India

    Pamali Mahasweta Nanda, Jaivinder Yadav, Devi Dayal & Rakesh Kumar

  2. Division of Neonatology, Department of Pediatrics, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India

    Praveen Kumar & Jogender Kumar

  3. Department of Pediatrics, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India

    Harvinder Kaur

  4. Department of Obstetrics and Gynaecology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India

    Pooja Sikka

Authors
  1. Pamali Mahasweta Nanda
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  2. Jaivinder Yadav
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  3. Devi Dayal
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  4. Rakesh Kumar
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  5. Praveen Kumar
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  6. Jogender Kumar
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  7. Harvinder Kaur
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  8. Pooja Sikka
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Contributions

PMN was primary investigator; PMN and JY were involved in conception of the study and drafting the manuscript; JY, DD, PK, JK, HK and PS were co-investigators, and advisors in study conduct and manuscript revision; DD, RK, PK were involved in revising the manuscript critically for important intellectual content. All authors have read the manuscript and approved it for final submission. All authors have agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. DD will act as the guarantor for this paper.

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Correspondence to Jaivinder Yadav.

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Nanda, P.M., Yadav, J., Dayal, D. et al. Estimation of Reference Values for External Genitalia Parameters in North Indian Preterm and Term Female Newborns. Indian J Pediatr 91, 548–555 (2024). https://doi.org/10.1007/s12098-023-04743-1

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  • DOI: https://doi.org/10.1007/s12098-023-04743-1

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