Supplementary Fetal Growth Curves

John G. Archie, Julianne S. Collins, and Robert Roger Lebel

June 19, 2006

The following growth curves are described in themanuscript entitled “Quantitative Standards for Fe-tal and Neonatal Autopsy.” While the tables in themanuscript are better suited for displaying these nu-merical data, some may still prefer charts, hence thereason for this document.

Most of these curves are constructed from regres-sions on data from multiple sources, and the remain-ing curves are derived from a single source. Allsources studied non-macerated tissue examined at au-topsy and excluded fetuses with obvious malforma-tions. (The one exception to this rule is hand lengthat later ages, which incorporates data from normallive borns.) Thus, these standards are designed toshow whether various measurements obtained at au-topsy are normal when compared to other seeminglynormal fetuses examined at autopsy.

The dotted, dash-dotted, and dashed lines corre-spond to plus or minus 1.00, 1.28, and 1.64 stan-dard deviations, respectively. Assuming the data arenormally distributed, these lines also correspond with16–84th, 10–90th, and 5–95th percentiles, respectively.Note that standard deviation data is not available forphiltrum length, chest circumference, abdominal cir-

cumference, small intestine length, and large intestinelength.

Contents

Weight Measurements 2

Body Weight (12–44 Weeks) . . . . . . . . . . 2Body Weight (12–24 Weeks) . . . . . . . . . . 3Brain Weight (12–44 Weeks) . . . . . . . . . 4Brain Weight (12–24 Weeks) . . . . . . . . . 5Thymus Weight (12–44 Weeks) . . . . . . . . 6Thymus Weight (12–24 Weeks) . . . . . . . . 7Lung Weight (12–44 Weeks) . . . . . . . . . . 8Lung Weight (12–24 Weeks) . . . . . . . . . . 9Heart Weight (12–44 Weeks) . . . . . . . . . 10Heart Weight (12–24 Weeks) . . . . . . . . . 11Liver Weight (12–44 Weeks) . . . . . . . . . . 12Liver Weight (12–24 Weeks) . . . . . . . . . . 13Spleen Weight (12–44 Weeks) . . . . . . . . . 14Spleen Weight (12–24 Weeks) . . . . . . . . . 15Adrenal Weight (12–44 Weeks) . . . . . . . . 16Adrenal Weight (12–24 Weeks) . . . . . . . . 17Pancreas Weight (20–42 Weeks) . . . . . . . . 18

Kidney Weight (12–44 Weeks) . . . . . . . . . 20Kidney Weight (12–24 Weeks) . . . . . . . . . 21

Linear Measurements 22

Crown-Heel Length (12–42 Weeks) . . . . . . 22Crown-Heel Length (12–24 Weeks) . . . . . . 23Crown-Rump Length (12–42 Weeks) . . . . . 24Crown-Rump Length (12–24 Weeks) . . . . . 25Head Circumference (12–42 Weeks) . . . . . . 26Biparietal Diameter (12–42 Weeks) . . . . . . 27Outer Canthal Distance (12–42 Weeks) . . . 28Inner Canthal Distance (12–42 Weeks) . . . . 29Philtrum Length (13–26 Weeks) . . . . . . . 30Chest Circumference (13–40 Weeks) . . . . . 31Inter-Nipple Distance (12–42 Weeks) . . . . . 32Inter-Nipple Distance (12–24 Weeks) . . . . . 33Abdominal Circumference (13–26 Weeks) . . 34Hand Length (13–42 Weeks) . . . . . . . . . . 35Foot Length (12–42 Weeks) . . . . . . . . . . 36Foot Length (12–24 Weeks) . . . . . . . . . . 37

Internal Measurements 38

Small Intestine Length (12–25 Weeks) . . . . 38Large Intestine Length (12–25 Weeks) . . . . 39

11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45

040

080

012

0018

0024

0030

0036

0042

0048

00 Body Weight (12−44 Weeks)

Postmenstrual Gestational Age (Weeks)

Wei

ght (

g)

1.00 SD; 16−84th percentile1.28 SD; 10−90th percentile1.64 SD; 5−95th percentile

Sources: Cussen et al. (1990), Gruenwald and Minh (1960), Hansen et al. (2003), and Wigglesworth and Singer (1991)

2

12 13 14 15 16 17 18 19 20 21 22 23 24

050

100

200

300

400

500

600

700

Body Weight (12−24 Weeks)

Postmenstrual Gestational Age (Weeks)

Wei

ght (

g)

1.00 SD; 16−84th percentile1.28 SD; 10−90th percentile1.64 SD; 5−95th percentile

Sources: Cussen et al. (1990), Gruenwald and Minh (1960), Hansen et al. (2003), and Wigglesworth and Singer (1991)

3

11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45

040

8012

016

020

024

028

032

036

040

044

048

052

0 Brain Weight (12−44 Weeks)

Postmenstrual Gestational Age (Weeks)

Wei

ght (

g)

1.00 SD; 16−84th percentile1.28 SD; 10−90th percentile1.64 SD; 5−95th percentile

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

4

12 13 14 15 16 17 18 19 20 21 22 23 24

05

1525

3545

5565

7585

9510

5Brain Weight (12−24 Weeks)

Postmenstrual Gestational Age (Weeks)

Wei

ght (

g)

1.00 SD; 16−84th percentile1.28 SD; 10−90th percentile1.64 SD; 5−95th percentile

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

5

11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45

01

23

45

67

89

1011

1213

1415

1617

Thymus Weight (12−44 Weeks)

Postmenstrual Gestational Age (Weeks)

Wei

ght (

g)

1.00 SD; 16−84th percentile1.28 SD; 10−90th percentile1.64 SD; 5−95th percentile

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

6

12 13 14 15 16 17 18 19 20 21 22 23 24

0.0

0.2

0.4

0.6

0.8

1.0

1.2

1.4

1.6

1.8

2.0

2.2

2.4 Thymus Weight (12−24 Weeks)

Postmenstrual Gestational Age (Weeks)

Wei

ght (

g)

1.00 SD; 16−84th percentile1.28 SD; 10−90th percentile1.64 SD; 5−95th percentile

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

7

11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45

05

1015

2025

3035

4045

5055

6065

7075

8085

Lung Weight (12−44 Weeks)

Postmenstrual Gestational Age (Weeks)

Wei

ght (

g)

1.00 SD; 16−84th percentile1.28 SD; 10−90th percentile1.64 SD; 5−95th percentile

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

8

12 13 14 15 16 17 18 19 20 21 22 23 24

01

23

45

67

89

1113

1517

1921

23Lung Weight (12−24 Weeks)

Postmenstrual Gestational Age (Weeks)

Wei

ght (

g)

1.00 SD; 16−84th percentile1.28 SD; 10−90th percentile1.64 SD; 5−95th percentile

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

9

11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45

02

46

810

1214

1618

2022

2426

2830

3234

Heart Weight (12−44 Weeks)

Postmenstrual Gestational Age (Weeks)

Wei

ght (

g)

1.00 SD; 16−84th percentile1.28 SD; 10−90th percentile1.64 SD; 5−95th percentile

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

10

12 13 14 15 16 17 18 19 20 21 22 23 24

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

Heart Weight (12−24 Weeks)

Postmenstrual Gestational Age (Weeks)

Wei

ght (

g)

1.00 SD; 16−84th percentile1.28 SD; 10−90th percentile1.64 SD; 5−95th percentile

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

11

11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45

020

4060

8010

012

014

016

018

020

022

0Liver Weight (12−44 Weeks)

Postmenstrual Gestational Age (Weeks)

Wei

ght (

g)

1.00 SD; 16−84th percentile1.28 SD; 10−90th percentile1.64 SD; 5−95th percentile

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

12

12 13 14 15 16 17 18 19 20 21 22 23 24

02

46

810

1418

2226

3034

38Liver Weight (12−24 Weeks)

Postmenstrual Gestational Age (Weeks)

Wei

ght (

g)

1.00 SD; 16−84th percentile1.28 SD; 10−90th percentile1.64 SD; 5−95th percentile

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

13

11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45

01

23

45

67

89

1012

1416

18Spleen Weight (12−44 Weeks)

Postmenstrual Gestational Age (Weeks)

Wei

ght (

g)

1.00 SD; 16−84th percentile1.28 SD; 10−90th percentile1.64 SD; 5−95th percentile

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

14

12 13 14 15 16 17 18 19 20 21 22 23 24

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 Spleen Weight (12−24 Weeks)

Postmenstrual Gestational Age (Weeks)

Wei

ght (

g)

1.00 SD; 16−84th percentile1.28 SD; 10−90th percentile1.64 SD; 5−95th percentile

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

15

11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45

01

23

45

67

89

1011

1213

1415

Adrenals Weight (12−44 Weeks)

Postmenstrual Gestational Age (Weeks)

Wei

ght (

g)

1.00 SD; 16−84th percentile1.28 SD; 10−90th percentile1.64 SD; 5−95th percentile

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

16

12 13 14 15 16 17 18 19 20 21 22 23 24

0.0

0.4

0.8

1.2

1.6

2.0

2.4

2.8

3.2

Adrenals Weight (12−24 Weeks)

Postmenstrual Gestational Age (Weeks)

Wei

ght (

g)

1.00 SD; 16−84th percentile1.28 SD; 10−90th percentile1.64 SD; 5−95th percentile

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

17

20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42

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

6.5

Pancreas Weight (20−42 Weeks)

Postmenstrual Gestational Age (Weeks)

Wei

ght (

g)

1.00 SD; 16−84th percentile1.28 SD; 10−90th percentile1.64 SD; 5−95th percentile

Source: Wigglesworth and Singer (1991)

18

This page is intentionally left blank.

19

11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45

02

46

812

1620

2428

3236

4044

Kidney Weight (12−44 Weeks)

Postmenstrual Gestational Age (Weeks)

Wei

ght (

g)

1.00 SD; 16−84th percentile1.28 SD; 10−90th percentile1.64 SD; 5−95th percentile

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

20

12 13 14 15 16 17 18 19 20 21 22 23 24

0.0

1.0

2.0

3.0

4.0

5.0

6.0

7.0

8.0

Kidney Weight (12−24 Weeks)

Postmenstrual Gestational Age (Weeks)

Wei

ght (

g)

1.00 SD; 16−84th percentile1.28 SD; 10−90th percentile1.64 SD; 5−95th percentile

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

21

11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43

050

100

150

200

250

300

350

400

450

500

550

600

Crown−Heel Length (12−42 Weeks)

Postmenstrual Gestational Age (Weeks)

Leng

th (

mm

)

1.00 SD; 16−84th percentile1.28 SD; 10−90th percentile1.64 SD; 5−95th percentile

Sources: Cussen et al. (1990), Hansen et al. (2003), and Wigglesworth and Singer (1991)

22

12 13 14 15 16 17 18 19 20 21 22 23 24

020

4060

8012

016

020

024

028

032

0Crown−Heel Length (12−24 Weeks)

Postmenstrual Gestational Age (Weeks)

Leng

th (

mm

)

1.00 SD; 16−84th percentile1.28 SD; 10−90th percentile1.64 SD; 5−95th percentile

Sources: Cussen et al. (1990), Hansen et al. (2003), and Wigglesworth and Singer (1991)

23

11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43

040

8012

016

020

024

028

032

036

040

0Crown−Rump Length (12−42 Weeks)

Postmenstrual Gestational Age (Weeks)

Leng

th (

mm

)

1.00 SD; 16−84th percentile1.28 SD; 10−90th percentile1.64 SD; 5−95th percentile

Sources: Cussen et al. (1990), Hansen et al. (2003), and Wigglesworth and Singer (1991)

24

12 13 14 15 16 17 18 19 20 21 22 23 24

020

4060

8010

012

014

016

018

020

022

024

0 Crown−Rump Length (12−24 Weeks)

Postmenstrual Gestational Age (Weeks)

Leng

th (

mm

)

1.00 SD; 16−84th percentile1.28 SD; 10−90th percentile1.64 SD; 5−95th percentile

Sources: Cussen et al. (1990), Hansen et al. (2003), and Wigglesworth and Singer (1991)

25

11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43

020

6010

014

018

022

026

030

034

038

0Head Circumference (12−42 Weeks)

Postmenstrual Gestational Age (Weeks)

Leng

th (

mm

)

1.00 SD; 16−84th percentile1.28 SD; 10−90th percentile1.64 SD; 5−95th percentile

Source: Guihard-Costa et al. (2003)

26

11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43

05

1525

3545

5565

7585

9510

5Biparietal Diameter (12−42 Weeks)

Postmenstrual Gestational Age (Weeks)

Leng

th (

mm

)

1.00 SD; 16−84th percentile1.28 SD; 10−90th percentile1.64 SD; 5−95th percentile

Source: Guihard-Costa et al. (2003)

27

11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43

05

1015

2025

3035

4045

5055

6065

7075

Outer Canthal Distance (12−42 Weeks)

Postmenstrual Gestational Age (Weeks)

Leng

th (

mm

)

1.00 SD; 16−84th percentile1.28 SD; 10−90th percentile1.64 SD; 5−95th percentile

Source: Guihard-Costa et al. (2003)

28

11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43

12

34

56

78

911

1315

1719

2123

25Inner Canthal Distance (12−42 Weeks)

Postmenstrual Gestational Age (Weeks)

Leng

th (

mm

)

1.00 SD; 16−84th percentile1.28 SD; 10−90th percentile1.64 SD; 5−95th percentile

Source: Guihard-Costa et al. (2003)

29

13 14 15 16 17 18 19 20 21 22 23 24 25 26

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 Philtrum Length (13−26 Weeks)

Postmenstrual Gestational Age (Weeks)

Leng

th (

mm

)

Source: Chambers et al. (1993)

30

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

020

4060

8012

016

020

024

028

032

0Chest Circumference (13−40 Weeks)

Postmenstrual Gestational Age (Weeks)

Leng

th (

mm

)

Sources: Bhat et al. (1989) and Chambers et al. (1993)

31

11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43

05

1020

3040

5060

7080

90Inter−Nipple Distance (12−42 Weeks)

Postmenstrual Gestational Age (Weeks)

Leng

th (

mm

)

1.00 SD; 16−84th percentile1.28 SD; 10−90th percentile1.64 SD; 5−95th percentile

Source: Guihard-Costa et al. (2003)

32

12 13 14 15 16 17 18 19 20 21 22 23 24

02

46

812

1620

2428

3236

4044

48Inter−Nipple Distance (12−24 Weeks)

Postmenstrual Gestational Age (Weeks)

Leng

th (

mm

)

1.00 SD; 16−84th percentile1.28 SD; 10−90th percentile1.64 SD; 5−95th percentile

Source: Guihard-Costa et al. (2003)

33

13 14 15 16 17 18 19 20 21 22 23 24 25 26

010

3050

7090

110

130

150

170

Abdominal Circumference (13−26 Weeks)

Postmenstrual Gestational Age (Weeks)

Leng

th (

mm

)

Source: Chambers et al. (1993)

34

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

05

1015

2025

3035

4045

5055

6065

7075

Hand Length (13−42 Weeks)

Postmenstrual Gestational Age (Weeks)

Leng

th (

mm

)

1.00 SD; 16−84th percentile1.28 SD; 10−90th percentile1.64 SD; 5−95th percentile

Sources: Chambers et al. (1993) and Madhulika et al. (1989)

35

11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43

05

1020

3040

5060

7080

90Foot Length (12−42 Weeks)

Postmenstrual Gestational Age (Weeks)

Leng

th (

mm

)

1.00 SD; 16−84th percentile1.28 SD; 10−90th percentile1.64 SD; 5−95th percentile

Sources: Hansen et al. (2003) and Wigglesworth and Singer (1991)

36

12 13 14 15 16 17 18 19 20 21 22 23 24

02

46

812

1620

2428

3236

4044

48Foot Length (12−24 Weeks)

Postmenstrual Gestational Age (Weeks)

Leng

th (

mm

)

1.00 SD; 16−84th percentile1.28 SD; 10−90th percentile1.64 SD; 5−95th percentile

Sources: Hansen et al. (2003) and Wigglesworth and Singer (1991)

37

12 13 14 15 16 17 18 19 20 21 22 23 24 25

010

2030

4050

6070

8090

100

110

120

130

Small Intestine Length (12−25 Weeks)

Postmenstrual Gestational Age (Weeks)

Leng

th (

cm)

Source: FitzSimmons et al. (1988)

38

12 13 14 15 16 17 18 19 20 21 22 23 24 25

02

46

810

1214

1618

2022

2426

Large Intestine Length (12−25 Weeks)

Postmenstrual Gestational Age (Weeks)

Leng

th (

cm)

Source: FitzSimmons et al. (1988)

39

References

Bhat, G. J., K. Mukelabai, G. N. Shastri, and C. Tamina (1989,Jun). Anthropometric parameters of Zambian infants at birth.J Trop Pediatr 35 (3), 100–104.

Chambers, H. M., S. Knowles, A. Staples, M. Tamblyn, and E. A.Haan (1993, Apr). Anthropometric measurements in the secondtrimester fetus. Early Hum Dev 33 (1), 45–59.

Cussen, L., J. Scurry, G. Mitropoulos, C. McTigue, and J. Gross(1990, Apr). Mean organ weights of an Australian population offetuses and infants. J Paediatr Child Health 26 (2), 101–103.

FitzSimmons, J., A. Chinn, and T. H. Shepard (1988, Nov–Dec).Normal length of the human fetal gastrointestinal tract. Pediatr

Pathol 8 (6), 633–641.

Gruenwald, P. and H. N. Minh (1960, Sep). Evaluation of bodyand organ weights in perinatal pathology. I. Normal standardsderived from autopsies. Am J Clin Pathol 34 (3), 247–253.

Guihard-Costa, A.-M., F. Menez, and A. L. Delezoide (2003, Sep–Oct). Standards for dysmorphological diagnosis in human fe-tuses. Pediatr Dev Pathol 6 (5), 427–434.

Hansen, K., C. J. Sung, C. Huang, H. Pinar, D. B. Singer, and C. E.Oyer (2003, Mar–Apr). Reference values for second trimesterfetal and neonatal organ weights and measurements. Pediatr

Dev Pathol 6 (2), 160–167.

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 lowerlimb standards in newborn. Indian Pediatr 26 (7), 667–670.

Wigglesworth, J. S. and D. B. Singer (1991). Textbook of Fetal and

Perinatal Pathology. Amsterdam: Blackwell Publishers.

40