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International Journal of Legal Medicine

, Volume 130, Issue 5, pp 1333–1341 | Cite as

A method for estimating gestational age of fetal remains based on long bone lengths

  • Cristiana CarneiroEmail author
  • Francisco Curate
  • Eugénia Cunha
Original Article

Abstract

The estimation of gestational age (GA) in fetal human remains is important in forensic settings, particularly to assess fetal viability, in addition to often being the only biological profile parameter that can be assessed with some accuracy for non-adults. The length of long bone diaphysis is one of the most frequently used methods for fetal age estimation. The main objective of this study was to present a simple and objective method for estimating GA based on the measurements of the diaphysis of the femur, tibia, fibula, humerus, ulna, and radius. Conventional least squares regression equations (classical and inverse calibration approaches) and quick reference tables were generated. A supplementary objective was to compare the performance of the new formulae against previously published models. The sample comprised 257 fetuses (136 females and 121 males) with known GA (between 12 and 40 weeks) and was selected based on clinical and pathological information. All measurements were performed on radiographic images acquired in anonymous clinical autopsy records from spontaneous and therapeutic abortions in two Portuguese hospitals. The proposed technique is straightforward and reproducible. The models for the GA estimation are exceedingly accurate and unbiased. Comparisons between inverse and classical calibration show that both perform exceptionally well, with high accuracy and low bias. Also, the newly developed equations generally outperform earlier methods of GA estimation in forensic contexts. Quick reference tables for each long bone are now available. The obtained models for the estimation of gestational age are of great applicability in forensic contexts.

Keywords

Fetus Age estimation Long bones Radiography Regression equations 

Notes

Acknowledgments

The authors would like to thank Fundação para a Ciência e Tecnologia (grant no. SFRH/BPD/74015/2010).

References

  1. 1.
    Franklin D (2010) Forensic age estimation in human skeletal remains: current concepts and future directions. Leg Med 12:1–7. doi: 10.1016/j.legalmed.2009.09.001 CrossRefGoogle Scholar
  2. 2.
    Warren MW (1999) Radiographic determination of developmental age in fetuses and stillborns. J Forensic Sci 44:708–712PubMedGoogle Scholar
  3. 3.
    Adalian P (2001) Evaluation multiparametrique de la croissance foetal—Applications à la détermination de l’âge et du sexe. Doctoral Thesis, Faculté de Medecine, Université de la MéditerranéeGoogle Scholar
  4. 4.
    Adalian P, Piercecchi-Marti M-D, Bourliere-Najean B, Panuel M, Fredouille C, Dutour O, Leonetti G (2001) Postmortem assessment of fetal diaphyseal femoral length: validation of a radiographic methodology. J Forensic Sci 46(2):215–219CrossRefPubMedGoogle Scholar
  5. 5.
    Piercecchi-Marti M-D, Adalian P, Bourliere-Najean B, Gouvernet J, Maczel M, Dutour O, Leonetti G (2002) Validation of a radiographic method to establish new fetal growth standards: radio-anatomical correlation. J Forensic Sci 47:328–331CrossRefPubMedGoogle Scholar
  6. 6.
    Olsen ØE, Lie RT, Maartmann-Moe H, Pirhonen J, Lachman RS, Rosendahl K (2002) Skeletal measurements among infants who die during the perinatal period: new population-based reference. Pediatr Radiol 32(9):667–673CrossRefPubMedGoogle Scholar
  7. 7.
    Carneiro C, Curate F, Borralho P, Cunha E (2013) Radiographic fetal osteometry: approach on age estimation for the Portuguese population. Forensic Sci Int 231:139e1–139e5. doi: 10.1016/j.forsciint.2013.05.039 CrossRefGoogle Scholar
  8. 8.
    Thomson A (1899) The sexual differences of the foetal pelvis. J Anat Physiol 33:359–380PubMedPubMedCentralGoogle Scholar
  9. 9.
    Choi SC, Trotter M (1970) A statistical study of the multivariate structure and race-sex differences of American White and Negro fetal skeletons. Am J Phys Anthropol 33(3):307–312CrossRefPubMedGoogle Scholar
  10. 10.
    Fazekas IG, Kósa F (1978) Forensic fetal osteology. Akadémiai Kiadó, BudapestGoogle Scholar
  11. 11.
    Weaver DS (1980) Sex differences in the ilia of a known sex and age sample of fetal and infant skeletons. Am J Phys Anthropol 52:191–195CrossRefPubMedGoogle Scholar
  12. 12.
    Weaver DS (1998) Forensic aspects of fetal and neonatal skeletons. In: Reichs KJ (ed) Forensic osteology: advances in the identification of human remains, 2nd ed. Charles C. Thomas Publisher, Ltd, Springfield, pp 187–203Google Scholar
  13. 13.
    Scheuer L, Black S (2000) Developmental juvenile osteology. Elsevier, LondonGoogle Scholar
  14. 14.
    Scheuer JL, Musgrave JH, Evans SP (1980) The estimation of late fetal and perinatal age from limb bone length by linear and logarithmic regression. Ann Hum Biol 7(3):257–265CrossRefPubMedGoogle Scholar
  15. 15.
    Saunders SR (2008) Juvenile skeletons and growth-related studies. In: Katzenberg MA, Saunders SR (eds) Biological anthropology of the human skeleton, 2nd edn. Wiley-Liss, New Jersey, pp 117–148Google Scholar
  16. 16.
    Wilson LAB, Cardoso HFV, Humphrey LT (2011) On the reliability of a geometric morphometric approach to sex determination: a blind test of six criteria of the juvenile ilium. Forensic Sci Int 206(1–3):35–42CrossRefPubMedGoogle Scholar
  17. 17.
    Kósa F (2000) Application and role of anthropological research in the practice of forensic medicine. Acta Biol Szeged 44(1–4):179–188Google Scholar
  18. 18.
    Backer BJ, Dupras TL, Tocheri MW (2005) The osteology of infants and children. Texas A&M University PressGoogle Scholar
  19. 19.
    Sunderland EP, Smith CJ, Sunderland R (1987) A histological study of the chronology of initial mineralization in the human deciduous dentition. Archs Oral Biol 32:167–174CrossRefGoogle Scholar
  20. 20.
    Ubelaker DH (2006) Introduction to forensic anthropology. In: Schmitt A, Cunha E, Pinheiro J (eds) Forensic anthropology and medicine: complementary sciences from recovery to cause of death. Humana Press, New Jersey, pp 3–12CrossRefGoogle Scholar
  21. 21.
    Cunha E (2014) A antropologia forense passo a passo. In: Albino Gomes (ed) Enfermagem Forense, Vol. 2; Lidel, Lisboa, pp 280–288Google Scholar
  22. 22.
    Sherwood R, Meindl R, Robinson H, May R (2000) Fetal age: methods of estimation and effects of pathology. Am J Phys Anthropol 113:305–315CrossRefPubMedGoogle Scholar
  23. 23.
    Hadlock FP, Harrist RB, Deter RL, Park SK (1982) Fetal femur length as a predictor of menstrual age: sonographically measured. Am J Roentgenol 138:875–878CrossRefGoogle Scholar
  24. 24.
    Hadlock FP (1994) Ultrasound determination of menstrual age. In: Callen PW (ed) Ultrasonography in obstetics and gynecology. Saunders, Philadelphia, pp 86–101Google Scholar
  25. 25.
    Doubilet PM, Benson CB, Callen PW (2000) Ultrasound evaluation of fetal growth. In: Callen PW (ed) Ultrasonography in obstetrics and gynecology. 4thed Saunders, Philadelphia, pp 206–220Google Scholar
  26. 26.
    Huxley A, Angevine J Jr (1998) Determination of gestational age from lunar age assessments in human fetal remains. Forensic Sci 43(6):1254–1256Google Scholar
  27. 27.
    Olivier G, Pinneau H (1960) Nouvelle détermination de la taille foetale d’après les longueurs diaphysaires des os longs. Ann Med Leg 40:141–144PubMedGoogle Scholar
  28. 28.
    Kline RB (2010) Principles and practice of structural equation modeling. The Guildford Press, New YorkGoogle Scholar
  29. 29.
    Perini TA, Oliveira GL, Ornellas JS, Oliveira FP (2005) Technical error of measurement in anthropometry. Rev Bras Med Esporte 11(1):86–90CrossRefGoogle Scholar
  30. 30.
    Norton KI, Olds T (1996) Anthropometrica: a textbook of body measurement for sports & health courses. UNSW Press, KensingtonGoogle Scholar
  31. 31.
    Aykroyd RG, Lucy D, Pollard AM, Solheim T (1997) Technical note: regression analysis in adult age estimation. Am J Phys Anthropol 104:259–265CrossRefPubMedGoogle Scholar
  32. 32.
    Besalú E (2013) The connection between inverse and classical calibration. Talanta 116:45–49CrossRefPubMedGoogle Scholar
  33. 33.
    Walther BA, Moore JL (2005) The concepts of bias, precision and accuracy, and their use in testing the performance of species richness estimators, with a literature review of estimator performance. Ecography 28:815–829CrossRefGoogle Scholar
  34. 34.
    Curate F, Robles F, Rosa S, Matos S, Tavares A, António T (2015) Mortalidade Infantil na Ermida do Espírito Santo (Almada): entre o afecto e a marginalização. Al-Madan 19:68–76Google Scholar
  35. 35.
    Arthurs OJ, Calder AD, Klein WM (2015) Is there still a role for fetal and perinatal post-mortem radiography? J Forensic Radiol Imaging 3:5–11CrossRefGoogle Scholar
  36. 36.
    Jeanty P, Kirkpatrick C, Dramaix-Wilmet M, Struyven J (1981) Ultrasonic evaluation of fetal limb growth. Radiology 140:165–168CrossRefPubMedGoogle Scholar
  37. 37.
    White TD, Black MT, Folkens PA (2012) Human osteology. Academic Press, San DiegoGoogle Scholar
  38. 38.
    Lucy D, Aykroyd RG, Pollard AM (2002) Nonparametric calibration for age estimation. Appl Stat 51(2):183–196Google Scholar
  39. 39.
    Cardoso HF, Abrantes J, Humphrey LT (2014) Age estimation of immature human skeletal remains from the diaphyseal length of the long bones in the postnatal period. Int J Legal Med 128(5):809–824CrossRefPubMedGoogle Scholar
  40. 40.
    Uhl MN (2013) Age-at-death estimation. In: DiGangi EA, Moore MK (eds) Research methods in human skeletal biology. Elsevier, Waltham, pp 63–90CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Cristiana Carneiro
    • 1
    • 2
    • 3
    • 4
    Email author
  • Francisco Curate
    • 3
    • 4
    • 5
  • Eugénia Cunha
    • 3
    • 4
  1. 1.Garcia de Orta Hospital, EPEAlmadaPortugal
  2. 2.Lisbon School of Health TechnologyPolytechnic Institute of LisbonLisbonPortugal
  3. 3.Laboratory of Forensic Anthropology, Centre for Functional Ecology, Department of Life SciencesUniversity of CoimbraCoimbraPortugal
  4. 4.Research Centre for Anthropology and Health, Department of Life SciencesUniversity of CoimbraCoimbraPortugal
  5. 5.Interdisciplinary Center for Archaeology and Evolution of Human BehaviorUniversity of AlgarveFaroPortugal

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