Is prematurity a risk factor for developmental dysplasia of the hip?

Abstract

The aim of this prospective study was to investigate prematurity as a risk factor for developmental dysplasia of the hip (DDH). The hips of 221 infants (88 female, 133 male, mean age 31.11 weeks; standard deviation (sd) 2.51) who were born in the 34th week of gestation or earlier, and those of 246 infants (118 female, 128 male, mean age 40.22 weeks; sd 0.36) who were born in the 40th week of gestation, none of whom had risk factors for DDH, were compared using physical examination and ultrasound according to the technique of Graf, within one week, after the correction of gestational age to the 40th week after birth or one week since birth, respectively. Both hips of all infants were included in the study. Ortolani's and Barlow's tests and restricted abduction were accepted as positive findings on examination. There was a statistically significant difference between pre- and full-term infants, according to the incidence of mature and immature hips (p < 0.001). The difference in the proportion of infants with an α angle < 60° between the two groups was statistically significant (p < 0.001). The incidence of pathological dysplasia (α angle < 50 º) was not significantly different in the two groups (p = 1.000). The Barlow sign was present in two (0.5%) pre-term infants and in 14 (2.8%) full-term infants. These results suggests that prematurity is not a predisposing factor for DDH.

Developmental dysplasia of the hip: What has changed in the last 20 years?

“…Other risk factors include first born children, postural deformities, oligohydramnios and a positive family history [1,18] . Latest evidence suggests that prematurity is not a risk factor for DDH [19] .…”

Could low birth weight and preterm birth be associated with significant burden of hip osteoarthritis? A systematic review

“…Table 1 provides an overview of the included studies. The included studies comprised two cohort [ 32 , 34 ], one case-control [ 35 ], and two cross-sectional studies [ 36 , 37 ] published between 1993 and 2015. Two studies originated from Australia [ 32 , 35 ], two from the UK [ 34 , 36 ], and one from Turkey [ 37 ].…”

“…Hip bone abnormality included self-reported DDH [ 35 ], α-angle of the hip joint (suggestive of immature or pathologic hip) by ultrasound examination [ 37 ], and hip deformity by footprint angle and hip rotation [ 36 ]. Hip OA was defined by American College of Rheumatology (ACR) algorithms based on the presence of osteophytes and overall Kellgren and Lawrence (K-L) score assessed from hip radiographs [ 34 ], and hip arthroplasty for OA [ 32 ].…”

“…Two studies reported both LBW and preterm birth data [ 32 , 36 ], while the remainder collected data only on LBW [ 34 , 35 ] or preterm birth [ 37 ]. Birth weight information was collected from hospital records [ 36 , 37 ] and birth registries [ 34 , 35 ] for four of the included studies. One study collected self-reported birth weight data and whether the participant was born ≥ 2 weeks preterm [ 32 ].…”

Introductory Chapter: Five-Dimensional Approach to the Developmental Dysplasia of the Hip

“…Some authors include other mechanical intrauterine restrictions (large baby, multiple pregnancy), advanced maternal age and delivery-related conditions (post-maturity) [1,20]. It is worth noting that premature birth is not a risk factor for DDH [21]. Risk factors have limited clinical importance, however, due to both low sensitivity (10-27% of all infants who have DDH also have any risk factor) and low specificity (under 10% of children with risk factors have DDH) [22,23].…”