Lower birth rate in patients with total hip replacement

Artama, Miia; Skyttä, Eerik; Leino, Mikko; Kuitunen, Ilari; Eskelinen, Antti

doi:10.1080/17453674.2016.1193396

Cited by 10 publications

(10 citation statements)

References 17 publications

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“…Since the birth rate is lower after THR and patients might have concerns towards pregnancy after THR, these findings could possibly serve to decrease these concerns (16,20).…”

Section: Discussionmentioning

confidence: 99%

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Congenital anomalies in the offspring of women with total hip replacement: a nationwide register study in Finland

et al. 2020

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Background: Few previous studies have analysed the possible teratogenic effect of maternal total hip replacement (THR) on congenital anomalies. The aim of this study was to estimate the risk of major congenital anomalies in the offspring of women with THR. Furthermore, we compared the risks based on type of implant (metal-on-metal [MoM]/non-MoM). Methods: The study population for this register-based cohort study was gathered from six Finnish national registers. All fertile-aged females who underwent THR from 1980 to 2007 and three reference females for each THR patient without THR were selected. THR operation day was the start of the follow-up for both groups. Information on pregnancies, induced abortions (IA) and congenital anomalies was gathered for the years 1987–2007 and the proportions of congenital anomalies were compared. Results: In the THR group, 2429 women had 256 pregnancies, 205 (80.1%) deliveries and 51 (19.9%) IAs. In the reference group, 7276 women had 1670 pregnancies, 1443 (86.4%) deliveries and 236 (13.6%) IAs. There was no difference in the incidence of major anomalies between the THR (3.5%, n = 9) and the reference group (3.6%, n = 60), p = 0.91. In the THR group, there was no difference in the risk of major anomalies between the patients with a MoM-THR (10.5%, 2/19) and those with a non-MoM (2.9%, 7/241) (OR 3.93, 95% confidence interval 0.76–20.2; p = 0.13). Conclusions: Reassuringly, maternal THR does not appear to increase the risk of major congenital anomalies or pregnancies ending due to suspected foetal anomalies. Studies with larger study populations are needed to further assess the risk of anomalies in the offspring of women having MoM-THR.

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“…Since the birth rate is lower after THR and patients might have concerns towards pregnancy after THR, these findings could possibly serve to decrease these concerns (16,20).…”

Section: Discussionmentioning

confidence: 99%

“…These studies have, however, been relatively small local case series. Although it seems THR does not have an effect on the choice of delivery method nor on neonatal health (9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19), fertility rates are lower after THR (20), and some women with THR may still have concerns about becoming pregnant (16).…”

Section: Introductionmentioning

confidence: 99%

Congenital anomalies in the offspring of women with total hip replacement: a nationwide register study in Finland

et al. 2020

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“…This finding was due to the lower number of pregnancies per woman in the THR patient group. Our previous study showed that women have lower birth rates after THR (14).…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, neither pregnancy nor delivery decrease implant survival after THR (9)(10)(11)(12)(13). Women who have undergone THR seem to have lower fertility rates (14). One reason for the lower fertility rates might be that women have concerns about pregnancy and delivery after THR (9).…”

Section: Introductionmentioning

confidence: 99%

Induced Abortions Among Women Having Undergone Total Hip Replacement: A Nationwide Register Study in Finland

et al. 2018

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Background and Aims: No previous studies have analyzed the connection between total hip replacement and induced abortion. We evaluated the nationwide induced abortion rates among women with and without total hip replacement. Materials and Methods: Data for this cohort study were gathered from national registers from 1987 to 2007. All fertile-aged (15–44 years old) females who had undergone primary total hip replacement in Finland were selected. The total hip replacement patient group comprised 1713 women and the reference group 5148 women. Information on all pregnancies for both groups before and after total hip replacement/index date was gathered from the medical birth register and the register of induced abortion. Logistic regression model was used to analyze the adjusted odds ratio for induced abortion. Adjustment was made for age at induced abortion, parity, previous induced abortions, previous deliveries, and marital status. Results: Women had higher induced abortion proportions after total hip replacement (17.9%) compared with women before total hip replacement (14.1%) and the referents (13.9%), but the differences were not statistically significant. Women in the total hip replacement patient group had significantly more induced abortions after total hip replacement due to maternal health issues (14.7%) compared with the referents (2.7%), p = 0.003. Patients in the total hip replacement group were not more likely to have their pregnancy ending in induced abortion than the women in the reference group (odds ratio 1.32, 95% confidence interval 0.89–1.96, p = 0.17). However, in the adjusted analysis, there was a trend for higher risk for pregnancy to end in induced abortion in the total hip replacement group in relation to the reference group (adjusted odds ratio 1.50 (confidence interval 0.99–2.28, p = 0.05). Conclusion: The total hip replacement patient group had higher, but statistically insignificant, induced abortion proportions compared with the reference group before and after the operation. After total hip replacement, the patients were not more likely to have a pregnancy ending in induced abortion. This finding remained statistically insignificant after adjusting with possible confounders.

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“…It has been reported, however, that musculoskeletal trauma around the area of the pelvic ring and the femur can cause sexual dysfunction and dyspareunia [13,14]. Moreover, women in Finland who have undergone total hip replacement are reported to have a lower birth rate than women in the general population [15].…”

Section: Introductionmentioning

confidence: 99%

Birth rate after major trauma in fertile-aged women: a nationwide population-based cohort study in Finland

et al. 2022

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Background To date, only a few small studies have assessed the effects of major orthopedic traumas on the subsequent birth rate in fertile-aged woman. We assessed the incidences of traumatic brain injury (TBI) and fractures of the spine, pelvis, and hip or thigh and evaluated their association with the birth rate in fertile-aged woman. Methods In this retrospective register-based nationwide cohort study, data on all fertile-aged (15–44 years of age) women who sustained a TBI or fracture of the spine, pelvis, hip or thigh between 1998 and 2013 were retrieved from the Care Register for Health Care. A total of 22,780 women were included in TBI group, 3627 in spine fracture group, 1820 in pelvic fracture group, and 1769 in hip or thigh fracture group. The data were subsequently combined with data from the National Medical Birth Register. We used Cox regression model to analyze the hazard for a woman to give birth during 5-year follow-up starting from a major trauma. Women with wrist fractures (4957 women) formed a reference group. Results are reported as hazard ratios (HR) with 95% confidence intervals (CI). Results During 5-year follow-up after major trauma, 4324 (19.0%) women in the TBI group, 652 (18.0%) in the spine fracture group, 301 (16.5%) in the pelvic fracture group, 220 (12.4%) in the hip or thigh fracture group, and 925 (18.7%) in the wrist fracture group gave birth. The cumulative birth rate was lower in the hip or thigh fracture group in women aged 15–24 years (HR 0.72, CI 0.58–0.88) and 15–34 years (HR 0.65, CI 0.52–0.82). Women with pelvic fracture aged 25–34 years also had a lower cumulative birth rate (HR 0.79, CI 0.64–0.97). For spine fractures and TBIs, no reduction in cumulative birth rate was observed. Vaginal delivery was the primary mode of delivery in each trauma group. However, women with pelvic fractures had higher rate of cesarean section (23.9%), when compared to other trauma groups. Conclusions Our results suggest that women with thigh, hip, or pelvic fractures had a lower birth rate in 5-year follow-up. Information gained from this study will be important in clinical decision making when women with previous major trauma are considering becoming pregnant and giving birth.

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Lower birth rate in patients with total hip replacement

Cited by 10 publications

References 17 publications

Congenital anomalies in the offspring of women with total hip replacement: a nationwide register study in Finland

Congenital anomalies in the offspring of women with total hip replacement: a nationwide register study in Finland

Induced Abortions Among Women Having Undergone Total Hip Replacement: A Nationwide Register Study in Finland

Birth rate after major trauma in fertile-aged women: a nationwide population-based cohort study in Finland

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