Is Prematurity a Protective Factor Against Developmental Dysplasia of the Hip? A Retrospective Analysis of 660 Newborns

Koob, Sebastian; Garbe, W.; Bornemann, Rahel; Plöeger, Milena M.; Sebastian, Shaji; Gathen, Martin; Placzek, Richard

doi:10.1055/a-1161-8984

Cited by 12 publications

(12 citation statements)

References 8 publications

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“…Smaller infants have more space in the pelvis and thus Ortolani positivity is not common. Our result is in agreement with some recent previous studies [24,25]. There are also controversial results.…”

Section: Discussionsupporting

confidence: 92%

Known risk factors of the developmental dysplasia of the hip predicting more severe clinical presentation and failure of Pavlik harness treatment

et al. 2023

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Purpose Developmental dysplasia of the hip (DDH) varies from mild instability of the hip to subluxation or total dislocation of the joint. Well-known risk factors of DDH include pre-natal breech position, female sex, positive family history, hip side, primiparity and the mode of delivery. Aim of the present study was to further evaluate known risk-factors of DDH, find associations with more severe dysplasia (characterized with Ortolani positivity) and find risk factors of failure of the Pavlik harness treatment. Material and methods All children with the diagnosis of DDH treated in Tampere University hospital in the years 1998–2018 were retrospectively identified for the study and the data was collected from the medical records. Teratological dislocations (n = 3) were excluded from the analysis. Total of 945 patients were included. Results Breech presentation was strongly associated with Ortolani positivity (p < 0.001). Breech presentation was not associated with ending up for spica casting and/or operative treatment (p = 0.291) despite the association with Ortolani positivity. Ortolani positivity (p = 0.002), positive family history (p = 0.013) and girl sex (p = 0.029) were associated with ending up for spica casting and/or operative treatment. Conclusion Breech presentation seems to increase the risk of Ortolani positive DDH. However, these infants are likely to recover with initially started Pavlik harness treatment, as it was not associated with elevated risk for undergoing more robust treatments. Positive family history and girl sex are associated with the most severe cases of developmental dysplasia of the hip, and it may predispose to the failure of the Pavlik harness treatment.

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Section: Discussionsupporting

confidence: 92%

Known risk factors of the developmental dysplasia of the hip predicting more severe clinical presentation and failure of Pavlik harness treatment

et al. 2023

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“…Smaller infants have more space in the pelvis and thus Ortolani positivity is not common. Our result is in agreement with some recent previous studies [22,23]. There are also controversial results.…”

Section: Discussionsupporting

confidence: 92%

Known risk factors of the developmental dysplasia of the hip predicting more severe clinical presentation and failure of Pavlik harness treatment

Lankinen

Bakti

Helminen

et al. 2022

Preprint

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Purpose. Developmental dysplasia of the hip (DDH) varies from mild instability of the hip to subluxation or total dislocation of the joint. Well-known risk factors of DDH include pre-natal breech position, female sex, positive family history, hip side, primiparity and the mode of delivery. Aim of the present study was to further evaluate known risk-factors of DDH, find associations with more severe dysplasia (characterized with Ortolani positivity) and find risk factors of failure of the Pavlik harness treatment. Material and methods. All children with the diagnosis of DDH treated in Tampere University hospital in the years 1998-2018 were retrospectively identified for the study and the data was collected from the medical records. Total of 948 patients were included.Results. Breech presentation was strongly associated with Ortolani positivity (p<0.001). Among breech born infants C-section was strongly associated with Ortolani positivity (p<0.001) (OR 1.833, CI95% 1.332-2.524), whereas vaginal delivery was not (p=0.420). Breech presentation was not associated with ending up for spica casting and/or operative treatment (p=0.849) despite the association with Ortolani positivity.Ortolani positivity (p=0.002), positive family history (p=0.013) and primiparity (p=0.048) were associated with ending up for spica casting and/or operative treatment. Conclusion. Breech presentation seems to increase the risk of Ortolani positive DDH. However, these infants are likely to recover with initially started Pavlik harness treatment, as it was not associated with elevated risk for undergoing more robust treatments. Positive family history is associated with the most severe cases of developmental dysplasia of the hip, and it may predispose to the failure of the Pavlik harness treatment.

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“…Duramaz et al [29] demonstrated an increase in acetabular maturity with increased gestational age using the Graf classification system. Koob et al, [26] Lange et al, [27] and Orak et al [23] all hypothesized that the increased maturity in fetal hips in preterm infants is related to decreased intrauterine restrictions. This would allow for muscular, cartilaginous and bone development to theoretically occur unhindered.…”

Section: Discussionmentioning

confidence: 99%

Is prematurity a risk factor for developmental dysplasia of the hip? A systematic review and meta-analysis

Burkhart¹,

McNassor²,

Acuña³

et al. 2022

Journal of Pediatric Orthopaedics B

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Developmental dysplasia of the hip (DDH) is the most common orthopedic disorder in newborns. Early recognition and diagnosis are critical to prevent long-term complications. While several risk factors have been established, the association between prematurity and DDH remains unclear. Our analysis sought to analyze the literature exploring the relationship between prematurity and DDH. Articles evaluating the relationship between prematurity and DDH published between 1 January 2000 and 1 February 2022 were queried, with 11 studies included for analysis. Overall, a total of 8720 patients were included. The gestational age ranged from 23 to 36 weeks for preterm and ≥37 weeks for term births. Seven studies agreed that gestational age did not have a significant impact on DDH. Pooled analysis of available data demonstrated no significant difference in DDH among preterm and term infants (OR, 1.11; 95% CI, 0.82–1.51; P = 0.49). Sub-group analysis of two studies reporting data on very preterm (≤32 weeks) and term infants revealed no significant difference in the occurrence of DDH (OR, 4.58; 95% CI, 0.09–244.78; P = 0.45). Four studies found early gestational age is associated with a significantly higher incidence of mature hips compared to late preterm or term babies. Similarly, pooled analysis demonstrated significantly lower Graf classification among preterm infants (OR, 0.13; 95% CI, 0.03–0.61; P = 0.009). Based on the current literature, our analysis found that prematurity is not strongly associated with DDH. Furthermore, early gestational age was associated with a significantly higher incidence of mature hips measured by Graf classification.

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Is Prematurity a Protective Factor Against Developmental Dysplasia of the Hip? A Retrospective Analysis of 660 Newborns

Cited by 12 publications

References 8 publications

Known risk factors of the developmental dysplasia of the hip predicting more severe clinical presentation and failure of Pavlik harness treatment

Known risk factors of the developmental dysplasia of the hip predicting more severe clinical presentation and failure of Pavlik harness treatment

Known risk factors of the developmental dysplasia of the hip predicting more severe clinical presentation and failure of Pavlik harness treatment

Is prematurity a risk factor for developmental dysplasia of the hip? A systematic review and meta-analysis

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