Positioning the Umbilicus in African Newborns with Large Anterior Abdominal Wall Defects

OBJECTIVE: We tried to determine the normal position of the umbilicus in African newborns with a potential application in aesthetically acceptable umbilical reconstruction. SUBJECTS AND METHODS: The study involves a cross-sectional study of 896 healthy neonates who underwent clinical abdominal examination and measurement of the distances between the xiphoid process and the umbilicus (XU), xiphoid process and the pubis (XP), umbilicus and the pubis (UP), umbilicus and the anterior superior iliac spine (UASIS), abdominal girth (AG), and inter anterior superior iliac spines (IASIS) distance. The gestational age at delivery, age at measurement, sex, AG measured across the umbilicus, birth weight (BW), body length, and body mass index of the newborns were recorded. The measurements were used to determine the location of the umbilicus and Pearson's correlation analysis performed to determine the relationships of the recorded neonatal parameters with the measurements. RESULTS: The mean XP was 11.97 ± 2.09 cm, XU = 7.94 ± 2.74 cm, UP = 4.26 ± 1.21 cm, UASIS = 5.79 ± 1.04 cm, and IASIS = 10.25 ± 1.54 cm. The BW, length, and AG significantly correlated with the distance between the XU, umbilicus and pubis, umbilicus and anterior superior iliac spine as well as the distance between the two anterior superior iliac spines. CONCLUSION: The position of the umbilicus is dependent on the selected participants' characteristics. We suggest that a UP: XU ratio of 0.55 should be used to position the umbilicus during umbilical reconstruction in African neonates.