title: Clitoral Length and Anogenital Ratio in Indian Newborn Girls.
abstract: OBJECTIVE
  To generate normative data on clitoris length, anogenital distance and anogenital ratio in Indian newborns.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Neonatal unit of a tertiary care teaching hospital in Kolkata.
  
  
  METHODS
  378 female neonates, who were hemo-dynamically stable without critical illness or chromosomal anomaly, and without any vulval hematoma or genital abnormalities.
  
  
  METHODS
  Measurements were recorded using a digital vernier caliper between 24-72 hours. Infant was held in position by an assistant, while the investigator measured clitoral length by gently retracting the labia majora. Anogenital distance (centre of the anus to posterior convergence of the fourchette) and anogenital ratio (anogenital distance divided by the distance from centre of the anus to base of the clitoris) was also measured.
  
  
  METHODS
  Gestational age- and birthweight-wise normative values of clitoral length, anogenital distance and anogenital ratios.
  
  
  RESULTS
  Mean clitoral length was 3.1 (1.54) mm for the whole cohort while anogenital distance and anogenital ratio were 10.2 (2.78) mm and 0.34 (0.07) mm, respectively. The gestation age-wise percentile charts of clitoral length, anogenital distance and anogenital ratio have been generated. There was no correlation between clitoral length and gestational age, body length, head circumference and birth weight. Correlations were also weak for anogenital distance.
  
  
  CONCLUSIONS
  The normative values generated can serve as reference standard in the assessment of clitoromegaly, ambiguous genitalia, virilizing effects and suspected in utero androgen exposure.
authors.affiliation: Departments of Pediatric Medicine and Neonatology, Medical College, Kolkata; *Department of Pharmacology, Institute of Postgraduate Medical Education and Research; RK Rural Hospital; Department of Pediatric Medicine, BC Roy PGIPS; Kolkata, West Bengal, India. Correspondence to: Dr Rakesh Mondal, Professor, Pediatrics and Pediatric Rheumatologist, Department of Pediatrics, Medical College, Kolkata; 88 college street, Kolkata 700 073, West Bengal, India. ivanrakesh2001@gmail.com.
authors.forename: Rakesh
authors.initials: R
authors.lastname: Mondal
authors.forename: Kaushani
authors.initials: K
authors.lastname: Chatterjee
authors.forename: Moumita
authors.initials: M
authors.lastname: Samanta
authors.forename: Avijit
authors.initials: A
authors.lastname: Hazra
authors.forename: Somosri
authors.initials: S
authors.lastname: Ray
authors.forename: Tapas Kumar
authors.initials: TK
authors.lastname: Sabui
authors.forename: Basanta
authors.initials: B
authors.lastname: Banerjee
authors.forename: Suman
authors.initials: S
authors.lastname: Das
authors.forename: Dibyendu
authors.initials: D
authors.lastname: Roychowdhury
authors.forename: Rupa
authors.initials: R
authors.lastname: Biswas
mesh_terms: D001003:Anal Canal / Q000033:anatomy & histology*; D002987:Clitoris / Q000033:anatomy & histology*; D003430:Cross-Sectional Studies; D012734:Disorders of Sex Development / Q000175:diagnosis; D005260:Female; D006801:Humans; D007194:India; D007231:Infant, Newborn; D012016:Reference Values