Supplementary Fetal Growth CurvesJohn G. Archie, Julianne S. Collins, and Robert Roger Lebel June 19, 2006

The following growth curves are described in the cumference, small intestine length, and manuscript entitled Quantitative Standards for Fe- length. tal and Neonatal Autopsy. While the tables in the manuscript are better suited for displaying these numerical data, some may still prefer charts, hence the Contents reason for this document. Most of these curves are constructed from regres- Weight Measurements Body Weight (1244 Weeks) . . . . sions on data from multiple sources, and the remainBody Weight (1224 Weeks) . . . . ing curves are derived from a single source. All Brain Weight (1244 Weeks) . . . sources studied non-macerated tissue examined at auBrain Weight (1224 Weeks) . . . topsy and excluded fetuses with obvious malformaThymus Weight (1244 Weeks) . . tions. (The one exception to this rule is hand length Thymus Weight (1224 Weeks) . . at later ages, which incorporates data from normal Lung Weight (1244 Weeks) . . . . live borns.) Thus, these standards are designed to Lung Weight (1224 Weeks) . . . . show whether various measurements obtained at auHeart Weight (1244 Weeks) . . . topsy are normal when compared to other seemingly Heart Weight (1224 Weeks) . . . normal fetuses examined at autopsy. Liver Weight (1244 Weeks) . . . . The dotted, dash-dotted, and dashed lines correLiver Weight (1224 Weeks) . . . . spond to plus or minus 1.00, 1.28, and 1.64 stanSpleen Weight (1244 Weeks) . . . dard deviations, respectively. Assuming the data are Spleen Weight (1224 Weeks) . . . normally distributed, these lines also correspond with Adrenal Weight (1244 Weeks) . . 1684th , 1090th , and 595th percentiles, respectively. Adrenal Weight (1224 Weeks) . . Note that standard deviation data is not available for philtrum length, chest circumference, abdominal cirPancreas Weight (2042 Weeks) . .

large intestine

Kidney Weight (1244 Weeks) . . . . . . . . . 20 Kidney Weight (1224 Weeks) . . . . . . . . . 21 Linear Measurements Crown-Heel Length (1242 Weeks) . . . . Crown-Heel Length (1224 Weeks) . . . . Crown-Rump Length (1242 Weeks) . . . Crown-Rump Length (1224 Weeks) . . . Head Circumference (1242 Weeks) . . . . Biparietal Diameter (1242 Weeks) . . . . Outer Canthal Distance (1242 Weeks) . Inner Canthal Distance (1242 Weeks) . . Philtrum Length (1326 Weeks) . . . . . Chest Circumference (1340 Weeks) . . . Inter-Nipple Distance (1242 Weeks) . . . Inter-Nipple Distance (1224 Weeks) . . . Abdominal Circumference (1326 Weeks) Hand Length (1342 Weeks) . . . . . . . . Foot Length (1242 Weeks) . . . . . . . . Foot Length (1224 Weeks) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37

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2 2 3 4 5 6 7 8 9 10 11 12 13 14 15 38 16 Internal Measurements Small Intestine Length (1225 Weeks) . . . . 38 17 18 Large Intestine Length (1225 Weeks) . . . . 39

Body Weight (1244 Weeks)4800 1.00 SD; 1684th percentile 1.28 SD; 1090th percentile 1.64 SD; 595th percentile

Weight (g)

0 11

400

800 1200

1800

2400

3000

3600

4200

13

15

17

19

21

23

25

27

29

31

33

35

37

39

41

43

45

Postmenstrual Gestational Age (Weeks)Sources: Cussen et al. (1990), Gruenwald and Minh (1960), Hansen et al. (2003), and Wigglesworth and Singer (1991) 2

Body Weight (1224 Weeks)1.00 SD; 1684th percentile 1.28 SD; 1090th percentile 1.64 SD; 595th percentile

Weight (g)

0

50 100

200

300

400

500

600

700

12

13

14

15

16

17

18

19

20

21

22

23

24

Postmenstrual Gestational Age (Weeks)Sources: Cussen et al. (1990), Gruenwald and Minh (1960), Hansen et al. (2003), and Wigglesworth and Singer (1991) 3

Brain Weight (1244 Weeks)120 160 200 240 280 320 360 400 440 480 520 1.00 SD; 1684th percentile 1.28 SD; 1090th percentile 1.64 SD; 595th percentile

Weight (g)

0 11

40

80

13

15

17

19

21

23

25

27

29

31

33

35

37

39

41

43

45

Postmenstrual Gestational Age (Weeks)Sources: Cussen et al. (1990), Gruenwald and Minh (1960), Hansen et al. (2003), Larroche (1977), and Wigglesworth and Singer (1991) 4

Brain Weight (1224 Weeks)1.00 SD; 1684th percentile 1.28 SD; 1090th percentile 1.64 SD; 595th percentile 105 Weight (g) 0 5 15 25 35 45 55 65 75 85 95

12

13

14

15

16

17

18

19

20

21

22

23

24

Postmenstrual Gestational Age (Weeks)Sources: Cussen et al. (1990), Gruenwald and Minh (1960), Hansen et al. (2003), Larroche (1977), and Wigglesworth and Singer (1991) 5

Thymus Weight (1244 Weeks)10 11 12 13 14 15 16 17 1.00 SD; 1684th percentile 1.28 SD; 1090th percentile 1.64 SD; 595th percentile

Weight (g)

0 11

1

2

3

4

5

6

7

8

9

13

15

17

19

21

23

25

27

29

31

33

35

37

39

41

43

45

Postmenstrual Gestational Age (Weeks)Sources: Cussen et al. (1990), Gruenwald and Minh (1960), Hansen et al. (2003), Larroche (1977), and Wigglesworth and Singer (1991) 6

Thymus Weight (1224 Weeks)2.4 1.00 SD; 1684th percentile 1.28 SD; 1090th percentile 1.64 SD; 595th percentile

Weight (g)

0.0

0.2

0.4

0.6

0.8

1.0

1.2

1.4

1.6

1.8

2.0

2.2

12

13

14

15

16

17

18

19

20

21

22

23

24

Postmenstrual Gestational Age (Weeks)Sources: Cussen et al. (1990), Gruenwald and Minh (1960), Hansen et al. (2003), Larroche (1977), and Wigglesworth and Singer (1991) 7

Lung Weight (1244 Weeks)10 15 20 25 30 35 40 45 50 55 60 65 70 75 80 85 1.00 SD; 1684th percentile 1.28 SD; 1090th percentile 1.64 SD; 595th percentile

Weight (g)

0 11

5

13

15

17

19

21

23

25

27

29

31

33

35

37

39

41

43

45

Postmenstrual Gestational Age (Weeks)Sources: Cussen et al. (1990), Gruenwald and Minh (1960), Hansen et al. (2003), Larroche (1977), and Wigglesworth and Singer (1991) 8

Lung Weight (1224 Weeks)1.00 SD; 1684th percentile 1.28 SD; 1090th percentile 1.64 SD; 595th percentile 23 Weight (g) 0 1 2 3 4 5 6 7 8 9 11 13 15 17 19 21

12

13

14

15

16

17

18

19

20

21

22

23

24

Postmenstrual Gestational Age (Weeks)Sources: Cussen et al. (1990), Gruenwald and Minh (1960), Hansen et al. (2003), Larroche (1977), and Wigglesworth and Singer (1991) 9

Heart Weight (1244 Weeks)10 12 14 16 18 20 22 24 26 28 30 32 34 1.00 SD; 1684th percentile 1.28 SD; 1090th percentile 1.64 SD; 595th percentile

Weight (g)

0 11

2

4

6

8

13

15

17

19

21

23

25

27

29

31

33

35

37

39

41

43

45

Postmenstrual Gestational Age (Weeks)Sources: Cussen et al. (1990), Gruenwald and Minh (1960), Hansen et al. (2003), Larroche (1977), and Wigglesworth and Singer (1991) 10

Heart Weight (1224 Weeks)1.00 SD; 1684th percentile 1.28 SD; 1090th percentile 1.64 SD; 595th percentile 6.0 Weight (g) 0.0 0.5 1.0 1.5 2.0 2.5 3.0 3.5 4.0 4.5 5.0 5.5

12

13

14

15

16

17

18

19

20

21

22

23

24

Postmenstrual Gestational Age (Weeks)Sources: Cussen et al. (1990), Gruenwald and Minh (1960), Hansen et al. (2003), Larroche (1977), and Wigglesworth and Singer (1991) 11

Liver Weight (1244 Weeks)1.00 SD; 1684th percentile 1.28 SD; 1090th percentile 1.64 SD; 595th percentile

Weight (g)

0 11

20

40

60

80

100

120

140

160

180

200

220

13

15

17

19

21

23

25

27

29

31

33

35

37

39

41

43

45

Postmenstrual Gestational Age (Weeks)Sources: Cussen et al. (1990), Gruenwald and Minh (1960), Hansen et al. (2003), Larroche (1977), and Wigglesworth and Singer (1991) 12

Liver Weight (1224 Weeks)38 1.00 SD; 1684th percentile 1.28 SD; 1090th percentile 1.64 SD; 595th percentile

Weight (g)

0

2

4

6

8 10

14

18

22

26

30

34

12

13

14

15

16

17

18

19

20

21

22

23

24

Postmenstrual Gestational Age (Weeks)Sources: Cussen et al. (1990), Gruenwald and Minh (1960), Hansen et al. (2003), Larroche (1977), and Wigglesworth and Singer (1991) 13

Spleen Weight (1244 Weeks)18 1.00 SD; 1684th percentile 1.28 SD; 1090th percentile 1.64 SD; 595th percentile

Weight (g)

0 11

1

2

3

4

5

6

7

8

9

10

12

14

16

13

15

17

19

21

23

25

27

29

31

33

35

37

39

41

43

45

Postmenstrual Gestational Age (Weeks)Sources: Cussen et al. (1990), Gruenwald and Minh (1960), Hansen et al. (2003), Larroche (1977), and Wigglesworth and Singer (1991) 14

Spleen Weight (1224 Weeks)0.0 0.1 0.2 0.3 0.4 0.5 0.6 0.7 0.8 0.9 1.0 1.1 1.2 1.3 1.4 1.5 1.00 SD; 1684th percentile 1.28 SD; 1090th percentile 1.64 SD; 595th percentile

Weight (g)

12

13

14

15

16

17

18

19

20

21

22

23

24

Postmenstrual Gestational Age (Weeks)Sources: Cussen et al. (1990), Gruenwald and Minh (1960), Hansen et al. (2003), Larroche (1977), and Wigglesworth and Singer (1991) 15

Adrenals Weight (1244 Weeks)1.00 SD; 1684th percentile 1.28 SD; 1090th percentile 1.64 SD; 595th percentile 15 Weight (g) 0 11 1 2 3 4 5 6 7 8 9 10 11 12 13 14

13

15

17

19

21

23

25

27

29

31

33

35

37

39

41

43

45

Postmenstrual Gestational Age (Weeks)Sources: Cussen et al. (1990), Gruenwald and Minh (1960), Hansen et al. (2003), Larroche (1977), and Wigglesworth and Singer (1991) 16

Adrenals Weight (1224 Weeks)3.2 1.00 SD; 1684th percentile 1.28 SD; 1090th percentile 1.64 SD; 595th percentile

Weight (g)

0.0

0.4

0.8

1.2

1.6

2.0

2.4

2.8

12

13

14

15

16

17

18

19

20

21

22

23

24

Postmenstrual Gestational Age (Weeks)Sources: Cussen et al. (1990), Gruenwald and Minh (1960), Hansen et al. (2003), Larroche (1977), and Wigglesworth and Singer (1991) 17

Pancreas Weight (2042 Weeks)1.00 SD; 1684th percentile 1.28 SD; 1090th percentile 1.64 SD; 595th percentile 6.5 Weight (g) 0.0 0.5 1.0 1.5 2.0 2.5 3.0 3.5 4.0 4.5 5.0 5.5 6.0

20

21

22

23

24

25

26

27

28

29

30

31

32

33

34

35

36

37

38

39

40

41

42

Postmenstrual Gestational Age (Weeks)Source: Wigglesworth and Singer (1991) 18

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19

Kidney Weight (1244 Weeks)44 1.00 SD; 1684th percentile 1.28 SD; 1090th percentile 1.64 SD; 595th percentile

Weight (g)

0 2 4 6 8 11

12

16

20

24

28

32

36

40

13

15

17

19

21

23

25

27

29

31

33

35

37

39

41

43

45

Postmenstrual Gestational Age (Weeks)Sources: Cussen et al. (1990), Gruenwald and Minh (1960), Hansen et al. (2003), Larroche (1977), and Wigglesworth and Singer (1991) 20

Kidney Weight (1224 Weeks)1.00 SD; 1684th percentile 1.28 SD; 1090th percentile 1.64 SD; 595th percentile

Weight (g)

0.0

1.0

2.0

3.0

4.0

5.0

6.0

7.0

8.0

12

13

14

15

16

17

18

19

20

21

22

23

24

Postmenstrual Gestational Age (Weeks)Sources: Cussen et al. (1990), Gruenwald and Minh (1960), Hansen et al. (2003), Larroche (1977), and Wigglesworth and Singer (1991) 21

CrownHeel Length (1242 Weeks)600 1.00 SD; 1684th percentile 1.28 SD; 1090th percentile 1.64 SD; 595th percentile

Length (mm)

0 11

50

100

150

200

250

300

350

400

450

500

550

13

15

17

19

21

23

25

27

29

31

33

35

37

39

41

43

Postmenstrual Gestational Age (Weeks)Sources: Cussen et al. (1990), Hansen et al. (2003), and Wigglesworth and Singer (1991) 22

CrownHeel Length (1224 Weeks)1.00 SD; 1684th percentile 1.28 SD; 1090th percentile 1.64 SD; 595th percentile

Length (mm)

0

20 40 60 80

120

160

200

240

280

320

12

13

14

15

16

17

18

19

20

21

22

23

24

Postmenstrual Gestational Age (Weeks)Sources: Cussen et al. (1990), Hansen et al. (2003), and Wigglesworth and Singer (1991) 23

CrownRump Length (1242 Weeks)1.00 SD; 1684th percentile 1.28 SD; 1090th percentile 1.64 SD; 595th percentile 400 Length (mm) 0 11 40 80 120 160 200 240 280 320 360

13

15

17

19

21

23

25

27

29

31

33

35

37

39

41

43

Postmenstrual Gestational Age (Weeks)Sources: Cussen et al. (1990), Hansen et al. (2003), and Wigglesworth and Singer (1991) 24

CrownRump Length (1224 Weeks)240 1.00 SD; 1684th percentile 1.28 SD; 1090th percentile 1.64 SD; 595th percentile

Length (mm)

0

20

40

60

80

100

120

140

160

180

200

220

12

13

14

15

16

17

18

19

20

21

22

23

24

Postmenstrual Gestational Age (Weeks)Sources: Cussen et al. (1990), Hansen et al. (2003), and Wigglesworth and Singer (1991) 25

Head Circumference (1242 Weeks)380 1.00 SD; 1684th percentile 1.28 SD; 1090th percentile 1.64 SD; 595th percentile

Length (mm)

0 20 11

60

100

140

180

220

260

300

340

13

15

17

19

21

23

25

27

29

31

33

35

37

39

41

43

Postmenstrual Gestational Age (Weeks)Source: Guihard-Costa et al. (2003) 26

Biparietal Diameter (1242 Weeks)1.00 SD; 1684th percentile 1.28 SD; 1090th percentile 1.64 SD; 595th percentile 105 Length (mm) 0 5 11 15 25 35 45 55 65 75 85 95

13

15

17

19

21

23

25

27

29

31

33

35

37

39

41

43

Postmenstrual Gestational Age (Weeks)Source: Guihard-Costa et al. (2003) 27

Outer Canthal Distance (1242 Weeks)75 1.00 SD; 1684th percentile 1.28 SD; 1090th percentile 1.64 SD; 595th percentile

Length (mm)

0 11

5

10

15

20

25

30

35

40

45

50

55

60

65

70

13

15

17

19

21

23

25

27

29

31

33

35

37

39

41

43

Postmenstrual Gestational Age (Weeks)Source: Guihard-Costa et al. (2003) 28

Inner Canthal Distance (1242 Weeks)25 1.00 SD; 1684th percentile 1.28 SD; 1090th percentile 1.64 SD; 595th percentile

Length (mm)

1 2 3 4 5 6 7 8 9 11

11

13

15

17

19

21

23

13

15

17

19

21

23

25

27

29

31

33

35

37

39

41

43

Postmenstrual Gestational Age (Weeks)Source: Guihard-Costa et al. (2003) 29

Philtrum Length (1326 Weeks)0.8 1.2 1.6 2.0 2.4 2.8 3.2 3.6 4.0 4.4 4.8 5.2 5.6 6.0 6.4 6.8

Length (mm)

13

14

15

16

17

18

19

20

21

22

23

24

25

26

Postmenstrual Gestational Age (Weeks)Source: Chambers et al. (1993) 30

Chest Circumference (1340 Weeks)320 Length (mm) 0 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 Postmenstrual Gestational Age (Weeks)Sources: Bhat et al. (1989) and Chambers et al. (1993) 31

20 40 60 80

120

160

200

240

280

InterNipple Distance (1242 Weeks)1.00 SD; 1684th percentile 1.28 SD; 1090th percentile 1.64 SD; 595th percentile

Length (mm)

0 11

5 10

20

30

40

50

60

70

80

90

13

15

17

19

21

23

25

27

29

31

33

35

37

39

41

43

Postmenstrual Gestational Age (Weeks)Source: Guihard-Costa et al. (2003) 32

InterNipple Distance (1224 Weeks)1.00 SD; 1684th percentile 1.28 SD; 1090th percentile 1.64 SD; 595th percentile 48 Length (mm) 0 2 4 6 8 12 16 20 24 28 32 36 40 44

12

13

14

15

16

17

18

19

20

21

22

23

24

Postmenstrual Gestational Age (Weeks)Source: Guihard-Costa et al. (2003) 33

Abdominal Circumference (1326 Weeks)

Length (mm)

0

10

30

50

70

90

110

130

150

170

13

14

15

16

17

18

19

20

21

22

23

24

25

26

Postmenstrual Gestational Age (Weeks)Source: Chambers et al. (1993) 34

Hand Length (1342 Weeks)1.00 SD; 1684th percentile 1.28 SD; 1090th percentile 1.64 SD; 595th percentile 75 Length (mm) 0 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 Postmenstrual Gestational Age (Weeks)Sources: Chambers et al. (1993) and Madhulika et al. (1989) 35

5

10

15

20

25

30

35

40

45

50

55

60

65

70

Foot Length (1242 Weeks)1.00 SD; 1684th percentile 1.28 SD; 1090th percentile 1.64 SD; 595th percentile 90 Length (mm) 0 11 5 10 20 30 40 50 60 70 80

13

15

17

19

21

23

25

27

29

31

33

35

37

39

41

43

Postmenstrual Gestational Age (Weeks)Sources: Hansen et al. (2003) and Wigglesworth and Singer (1991) 36

Foot Length (1224 Weeks)48 1.00 SD; 1684th percentile 1.28 SD; 1090th percentile 1.64 SD; 595th percentile

Length (mm)

0 2 4 6 8

12

16

20

24

28

32

36

40

44

12

13

14

15

16

17

18

19

20

21

22

23

24

Postmenstrual Gestational Age (Weeks)Sources: Hansen et al. (2003) and Wigglesworth and Singer (1991)

37

Small Intestine Length (1225 Weeks)100 110 120 130 Length (cm) 0 10 20 30 40 50 60 70 80 90

12

13

14

15

16

17

18

19

20

21

22

23

24

25

Postmenstrual Gestational Age (Weeks)Source: FitzSimmons et al. (1988)

38

Large Intestine Length (1225 Weeks)26 Length (cm) 0 2 4 6 8 10 12 14 16 18 20 22 24

12

13

14

15

16

17

18

19

20

21

22

23

24

25

Postmenstrual Gestational Age (Weeks)Source: FitzSimmons et al. (1988)

39

ReferencesBhat, G. J., K. Mukelabai, G. N. Shastri, and C. Tamina (1989, Jun). Anthropometric parameters of Zambian infants at birth. J Trop Pediatr 35 (3), 100104. Chambers, H. M., S. Knowles, A. Staples, M. Tamblyn, and E. A. Haan (1993, Apr). Anthropometric measurements in the second trimester fetus. Early Hum Dev 33 (1), 4559. Cussen, L., J. Scurry, G. Mitropoulos, C. McTigue, and J. Gross (1990, Apr). Mean organ weights of an Australian population of fetuses and infants. J Paediatr Child Health 26 (2), 101103. FitzSimmons, J., A. Chinn, and T. H. Shepard (1988, NovDec). Normal length of the human fetal gastrointestinal tract. Pediatr Pathol 8 (6), 633641. Gruenwald, P. and H. N. Minh (1960, Sep). Evaluation of body and organ weights in perinatal pathology. I. Normal standards derived from autopsies. Am J Clin Pathol 34 (3), 247253. Guihard-Costa, A.-M., F. Menez, and A. L. Delezoide (2003, Sep Oct). Standards for dysmorphological diagnosis in human fetuses. Pediatr Dev Pathol 6 (5), 427434. Hansen, K., C. J. Sung, C. Huang, H. Pinar, D. B. Singer, and C. E. Oyer (2003, MarApr). Reference values for second trimester fetal and neonatal organ weights and measurements. Pediatr Dev Pathol 6 (2), 160167. Larroche, J.-C. (1977). Developmental Pathology of the Neonate. London: Excerpta Medica. Madhulika, S. K. Kabra, V. Barar, A. Purohit, S. Saxena, U. Sharma, and R. K. Bansal (1989, Jul). Upper and lower limb standards in newborn. Indian Pediatr 26 (7), 667670. Wigglesworth, J. S. and D. B. Singer (1991). Textbook of Fetal and Perinatal Pathology. Amsterdam: Blackwell Publishers.

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