Perinatal risk factors for developmental dysplasia of the hip
- aPregnancy Outcome Unit,, bHealth Statistics Unit,, cEpidemiology Branch, South Australian Health Commission, PO Box 6, Rundle Mall, Adelaide, South Australia 5000Department of Orthopaedic Surgery,, dSouth Australian Birth Defects Register, Department of Medical Genetics, Women’s and Children’s Hospital, Adelaide
- Dr Annabelle Chan.
- Accepted 2 January 1997
Abstract
AIMS To identify perinatal risk factors for developmental dysplasia of the hip (DDH) and define the risk for each factor.
METHODS In this case control study, using logistic regression analysis, all 1127 cases of isolated DDH live born in South Australia in 1986-93 and notified to the South Australian Birth Defects Register were included; controls comprised 150 130 live births in South Australia during the same period without any notified congenital abnormalities.
RESULTS Breech presentation, oligohydramnios, female sex and primiparity were confirmed as risk factors for DDH. Significant findings were an increased risk for vaginal delivery over caesarean section for breech presentation (as well as an increased risk for emergency section over elective section), high birthweight (≥4000 g), postmaturity and older maternal age; multiple births and preterm births had a reduced risk. There was no increased risk for caesarean section in the absence of breech presentation. For breech presentation, the risk of DDH was estimated to be at least 2.7% for girls and 0.8% for boys; a combination of factors increased the risk.
CONCLUSIONS It is suggested that the risk factors identified be used as indications for repeat screening at 6 weeks of age and whenever possible in infancy. Other indications are family history and associated abnormalities.
