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Licensed Unlicensed Requires Authentication Published by De Gruyter March 28, 2020

Estimations of total serum testosterone levels in Nigerian term neonates at birth using anogenital distance measurements

  • Abiodun John Kareem EMAIL logo , Joshua Aderinsola Owa and Jerome Boluwaji Elutayo Elusiyan



In genital anomalies, measurement of total testosterone is required but is expensive and technically difficult to assay. Therefore, the measurement of anogenital distance, which is non-invasive and cheap, could be used to estimate total serum testosterone in neonates. The objective if this study is to determine the relationship between total serum testosterone and anogenital distance and estimate total serum testosterone levels in term neonates using measurements of anogenital distance.


This was a prospective cross-sectional study. Consecutive healthy term neonates were recruited in the first 72 h of postnatal life. Anogenital distance was measured with a digital vernier calliper. Total serum testosterone was determined using enzyme linked immunoassay.


A total of 240 term neonates comprising 124 (51.7%) males and 116 (48.3%) females were studied. The overall mean anogenital distance was 19.7 (7.7) mm and 26.5 (3.7) mm for males which was more than twice 12.4 (2.3) mm for females (t = 35.3, p < 0.001, 95% confidence interval [CI], 13–14). The overall mean total serum testosterone level was 267.1 (204.8) ng/dL; and 357.4 (241.7) ng/dL in males which was more than twice of 170.6 (80.7) ng/dL for females (t = 7.9, p < 0.001, 95% CI, 144–221). There was positive correlation between total serum testosterone and anogenital distance (r = 0.425, p < 0.001). The correlation was stronger in males than in females. The linear regression equation was as follows: total serum testosterone (ng/dL) = 44.3 + 11.3*AGD (mm) with 95% CI, 8–14.


The known value of anogenital distance could be used to estimate total serum testosterone levels in term neonates.


Dr. O. S. Smith of the Department of Chemical Pathology of Obafemi Awolowo University Teaching Hospital Complex (OAUTHC), Ile-Ife, Osun State, Nigeria is highly appreciated for providing the laboratory support in analysing the blood samples for total serum testosterone. We also appreciate Dr. O. T. Ojo and Dr. (Mrs.) A. O. Kareem for their assistance in the analysis of the data.

  1. Authors’ contributions: AJ Kareem – conception and design of the title, literature search, analysis and interpretation of the data, drafting of the article, revising the article critically and corresponding author. Approval of the version to be published. JA Owa – conception and design of the title, literature search, analysis and interpretation of the data, drafting of the article and revising the article critically. Approval of the version to be published. JBE Elusiyan – conception and design of the title, literature search, interpretation of the data, drafting of the article and revising the article critically. Approval of the version to be published.

  2. Research funding: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

  3. Employment or leadership: None declared.

  4. Honorarium: None declared.

  5. Conflicts of interest: The authors have disclosed no potential conflicts of interest, financial or otherwise.


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Received: 2019-11-02
Accepted: 2020-02-25
Published Online: 2020-03-28
Published in Print: 2020-05-26

©2020 Walter de Gruyter GmbH, Berlin/Boston

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