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Abstract
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.
Highlights
Data on normative clitoral sizes in newborns is relatively sparse and racial/ethnic differences have been reported
Since the technique of analyzing 17-hydroxyprogesterone (17-OHP) in filter paper blood samples was developed by Pang et al [3] in 1977, the utility of newborn screening for Congenital adrenal hyperplasia (CAH) has been amply demonstrated and several developed countries have established a newborn screening
All apparently well female term newborns with a gestational age of 40 ± 2 weeks and birth weight between 2.5 and 4.0 kg were considered for recruitment into the study
Summary
Data on normative clitoral sizes in newborns is relatively sparse and racial/ethnic differences have been reported. This study was performed to establish norms for clitoral size in term Ghanaian female newborns. Significant clitoromegaly at birth usually reflects virilization and suggests that the female foetus has been exposed to androgens during the intrauterine period [1]. Congenital adrenal hyperplasia (CAH) is the most common cause of virilization of a female foetus. Females with classical CAH usually have ambiguous genitalia or clitoromegaly which may be readily detected by genital examination [2]. Newborn screening for congenital adrenal adrenal hyperplasia is not carried out in the hospital but between May 2014 and April 2015 we diagnosed 4 females with CAH in a cohort of 9255 neonates through systematic newborn examination (unpublished data).
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