CLITORAL SIZE, ANOGENITAL DISTANCE AND NORMATIVE DATA IN TERM FEMALE NEWBORNS AT SAINT PAUL’S HOSPITAL MILLENNIUM MEDICAL COLLEGE, ADDIS ABABA ETHIOPIA, 2021.

Abstract

Abstract Background: Significant enlargement of clitoris during birth reflects virilization and suggesting the female foetus exposure to androgens during the intrauterine period. Measurement of clitoral size and anogenital distance helps early detection of intrauterine androgen exposure in female newborn neonates. This study may contribute baseline information on anogenital distance and clitoral size in female newborns in Ethiopia which can help as entry point for further evaluation before assigning their sexes to avoid long term sequelae including embedment of scarred self and embarrassment to the entire family and relatives. Objective: To assess clitoral size, anogenital distance and generate normative data in term female newborns in Saint Paul Hospital Millennium Medical College, Addis Ababa, Ethiopia, 2021. Method: Institution based descriptive cross-sectional study design was used and sample was determined using single population mean formula with final sample size of 284. Data was collected by means of standard questioner and direct measuring anogenital distance and clitoral size. Data entry was done using Epidata version 3.1 and analyzed by Statistical package for social sciences version 26. Result: The cutoff point for reference value in term female neonates using mean ± 2standard deviation of clitoral length and clitoral width were 6.06 – 12.47mm and 2.17 – 6.05mm respectively while anus fourchet distance 7.44 – 13.76mm , anus-clitoris distances 23.29 – 39.73mm and anogenital ratio of 0.2 0.34.Normogram of clitoral size and anogenital distance was generated based on gestational age. There were weak positive correlation of anus-clitoris distance with birth weight (r=0.218, p= 0.00) and birth length. (r =0.222, p= 0.00) and anus-fourchet distance with head circumference (r = 0.146, p =0.014) and with birth weight (r =0.145, p =0.014). Conclusion: provided overall mean±2SD reference values and generated normogram of clitoral size and anogenital distance using mean, standard deviations and gestational age. This simple, affordable and non invasive evaluation could help early identification and intervention of female newborns with potentially harmful conditions like congenital adrenal hyperplasia, particularly where newborn screening is not available. Key words: Clitoral size, anogenital distance, Ethiopia.