Supplemental figures and tables of a European multicenter validation study of the External Genitalia Score

Context: Standardized description of external genitalia is needed in the
assessment of children with atypical genitalia. Objectives: To validate
the External Genitalia Score (EGS), to present reference values for
preterm and term babies up to 24 months and correlate obtained scores with
anogenital distances (AGDs). Design, Setting: A European multicentre (n=8)
validation study  was conducted from 07/2016 until 07/2018.
Patients and Methods: EGS is based on the external masculinization score
but uses a gradual scale from female to male (range 0-12) and terminology
appropriate for both sexes. The reliability of EGS and AGD’s were
determined by the interclass correlation coefficient (ICC).
Cross-sectional data were obtained in 686 term (0-24 months), and 181
preterm babies and 111 babies with atypical genitalia. Results: ICC of EGS
in typical and atypical genitalia is excellent and good. Median EGS (10th
- 90th centile) in males < 28 weeks gestation is 10 (8.6-11.5); in
males 28-32 weeks 11.5 (9.2-12); in males 33-36 weeks 11.5 (10.5-12) and
in full-term males 12 (10.5-12). In all female babies, EGS is 0 (0-0). The
mean (SD) AGDl/u is 0.45 (0.1), with significant difference between AGDl/u
in males 0.49 (0.1) and females 0.39 (0.1) and in-between values in DSD
0.43 (0.1). AGDl/u correlates with EGS in males with typical genitalia and
in  atypical genitalia. Conclusions: EGS is a reliable and valid
tool to describe external genitalia in premature and term babies up to 24
months. EGS correlates with AGDl/u in males. It facilitates standardized
assessment, clinical decision-making and multicenter research.