Abstract
Objective:
To determine internipple distance and internipple index in prepubertal Turkish girls.
Methods:
The internipple distance and chest circumference of 667 healthy prepubertal Turkish girls aged 6 to 11 years were measured in a school screening program in Düzce. Measurements were performed at the end of expiration with a standard non-stretch tape measure graduated in millimeters with the arms hanging in a relaxed position on the sides of the body. The internipple distance was measured between the centers of both nipples, and chest circumference was measured across the internipple line. The internipple index was calculated by dividing the internipple distance (cm) x100 by the chest circumference (cm). Age specific internipple index reference curves were constructed and smoothed with the Lambda-Mu-Sigma method. Mean and standard deviations of internipple distance and internipple index were calculated according to decimal ages.
Results:
Age was found to be positively correlated with internipple distance and chest circumference, while it was negatively correlated with internipple index. The reference values of internipple index, including 3rd, 10th, 25th, 50th, 75th, 90th, and 97th percentiles, and standard deviations were calculated for prepubertal girls.
Conclusion:
The reference ranges provided by this study might be helpful for the evaluation of syndromic cases by serving as normative data for internipple index in prepubertal girls aged 6-11 years in Turkey although ethnic differences may affect applicability to other countries.
Keywords: Internipple distance, internipple index, Turkey
Read the full text
6 sections · 5 figures · PDF
Create your free account to read the full text.
- Full text with figures and tables
- PDF and supplementary files
- Access on every Galenos journal
One Galenos account works on every Galenos journal site.
References
Chen H, Espiritu C, Casquejo C, Boriboon K, Whoolley P Jr. Inter-nipple distance in normal children from birth to 14 years and in children with Turner’s, Noonan’s, Down’s and other aneuploides. Growth 1974;38:421-436.
Merlob P. Congenital malformations and developmental changes of the breast: a neonatologist view. J Pediatr Endocrinol Metab 2003;16:471-485.
Gürsoy S, Erçal D. Turner Syndrome and Its Variants. J Pediatr Res 2017;4:171-175.
Morgan T. Turner Syndrome: Diagnosis and Management. Am Fam Physician 2007;76:405-410.
Savendahl L, Davenport ML. Delayed diagnoses of Turner syndrome: Proposed guidelines for change. J Pediatr 2000;137:455-459.
Moreno-Garcia M, Fernandez-Martinez FJ, Barreiro Miranda E. Chromosomal anomalies in patients with short stature. Pediatr Int 2005;47:546-549.
Völkl TMK, Degenhardt K, Koch A, Simm D, Dörr HG, Singer H. Cardiovascular anomalies in children and young adults with Ullrich-Turner syndrome the Erlangen experience. Clin Cardiol 2005;28:88-92.
Elsheikh M, Casadei B, Conway GS, Wass JA. Hypertension is a major risk factor for aortic root dilatation in women with Turner syndrome. Clin Endocrinol (Oxf) 2001;54:69-73.
Mazzanti L, Cacciari E, Congenital heart disease in patients with Turner’s syndrome. Italian Study Group for Turner Syndrome (ISGTS). J Pediatr 1998;133:688-692.
Collins E. The illusion of widely spaced nipples in the Noonan and the Turner syndromes. J Pediatr 1973;83:557-561.
Arslanoğlu I, Topçu B, Özkul-Tandoğan M, Coşgun E, Oğuzhan T, Turan S, Yavuz T, Uzun H, Şenses DA, Kocabay K. Düzce İl Merkezi İlköğretim Öğrencisi Kız Çocuklarında Meme Evreleri ve Yaş İlişkisi. XIII. Ulusal Pediatrik Endokrinoloji Kongresi Kitabı, 137, Antalya, 2009.
Marshall WA, Tanner JM. Variations in pattern of pubertal changes in girls. Arch Dis Child 1969;44:291-303.
Pan H, Cole TJ. LMS Chartmaker. 2011. Last accessed date: Agust, 2019). Available at: http://www.healthforallchildren.co.uk
Cole TJ, Green PJ. Smoothing reference centile curves: The LMS method and penalized likelihood. Stat Med 1992;11:1305-1319.
Sivan Y, Merlob P, Reisner SH. Sternum length, torso length, and internipple distance in newborn infants. Pediatrics 1983;72:523-525.
Fok TF, Hon KL, Wong E, Ng PC, So HK, Lau J, Chow CB, Lee WH; Hong Kong Neonatal Measurements Working Group. Trunk anthropometry of Hong Kong Chinese infants. Early Hum Dev 2005;81:781-790.
Ejiwunmi AB, Okanlawon OA, Ojo OO. Interpupillary and internipple distances and ear lengths in Nigeran newborns. Ann Trop Paediatr 1984;4:103-106.
Mehes K, Kitzveger E. Inner canthal and intermamillary indices in the Newborn infant. J Pediatr 1974;85:90-92.
Leung AK, Kao CP, Sauve RS, Fang JH, Leong AG, Liu EK. Internipple distance and internipple index. J Natl Med Assoc 2004;96:1092-1096.
Pelz L. Intermammillary index in children. Kinderarztl Prax 1972;40:257-258.
Faridi MMA, Dhingra P. Internipple measurements in Indian neonates. S Afr J CH 2013;7:105-107.
Feingold M, Bossert WH. Normal values for selected physical parameters: an aid to syndrome delineation. Birth Defects Orig Artic Ser 1974;10:1-16.
