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Abstract
ObjectiveThis study measured anogenital distance (AGD) during late second/early third trimester of pregnancy to confirm previous findings that AGD can be measured noninvasively in the fetus using ultrasound and further showed differences in reference ranges between populations.MethodTwo hundred ten singleton pregnancies were recruited at the Rosie Hospital, Cambridge, UK. A 2D ultrasound was performed between 26 and 30 weeks of pregnancy. AGD was measured from the centre of the anus to the base of the scrotum in males and to the posterior convergence of the fourchette in females.ResultsA significant difference in AGD between males and females (P < .0001) was found, replicating previous results with a significant correlation between estimated fetal weight (EFW) and AGD in males only (P = .006). A comparison of AGD using reference data from an Israeli sample (n = 118) and our UK sample (n = 208) showed a significant difference (P < .0001) in both males and females, after controlling for gestational age (GA).ConclusionOur results confirm that AGD measurement in utero using ultrasound is feasible. In addition, there are strong sex differences, consistent with previous suggestions that AGD is influenced by prenatal androgen exposure. AGD lengths differ between the UK and Israel; therefore, population‐specific normative values may be required for accurate clinical assessments.
Highlights
Anogenital distance (AGD) refers to the length of the perineal area between the anus and genitals.[1,2,3] AGD has been implicated as a predictor of androgen‐related outcomes in later life[4] including reproductive[5,6] outcomes
This study aims to further establish the feasibility of measuring AGD during the late second/early third trimester of pregnancy, for the first time in a UK sample, in particular to test for sex differences in AGD, and to assess population‐specific reference ranges, by comparing UK measures with those collected in Israel
We identify the need for population‐specific normative charts if this measure is to be used clinically and of diagnostic value
Summary
Anogenital distance (AGD) refers to the length of the perineal area between the anus and genitals.[1,2,3] AGD has been implicated as a predictor of androgen‐related outcomes in later life[4] including reproductive[5,6] outcomes. The sexual dimorphism can be observed from as early as 11 to 13 weeks of fetal gestation in humans.[3,12] AGD continues to increase after birth and is correlated with birth weight,[11,13] and the differences observed in AGD prenatally are maintained across an individual's lifespan.[2] Unlike with other proxy measures of early hormone exposure[14] such as 2D:4D or penile length,[15] postnatal hormonal exposure has not been
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