Risk Factors and Screening Timing for Developmental Dysplasia of the Hip in Preterm Infants

Overview

Journal Clin Exp Pediatr

Specialty Pediatrics

Date 2021 Nov 16

PMID 34784658

Citations 8

Authors

Ga Won Jeon

Hye Jung Choo

Yong Uk Kwon

Affiliations

Soon will be listed here.

Abstract

Background: The delayed diagnosis of developmental dysplasia of the hip (DDH) requires complex treatment and sometimes progresses to hip osteoarthritis.

Purpose: This study aimed to evaluate the risk factors and screening time for DDH in preterm infants.

Methods: A total of 155 preterm infants with a gestational age <32 weeks screened for DDH with ultrasonography were enrolled in this retrospective chart review.

Results: The incidence of DDH was 6.45% (10 of 155). Gestational age, birth weight, sex ratio, and breech presentation did not differ significantly between infants treated for DDH (n=10) and nontreated infants (n=145) (gestational age, 29.2±1.4 weeks vs. 29.6±2.0 weeks, P=0.583; birth weight, 1,240±237 g vs. 1,295±335 g, P=0.607; female sex, 7 of 10 (70.0%) vs. 77 of 145 (53.1%), P=0.346; and breech presentation, 5 of 10 (50.0%) vs. 43 of 145 (29.7%), P=0.286, respectively). Performing the first ultrasonography earlier than 38 weeks of postmenstrual age (PMA) increased the risk of an abnormal finding by 3.76 times compared to performing it at ≥38 weeks of PMA. These abnormal findings on ultrasonography resolved spontaneously. Breech presentation increased the risk of minor abnormal findings on the first ultrasonography by 3.11 times versus nonbreech presentation and resolved spontaneously. DDH in preterm infants did not occur predominantly on the left side or in infants born with breech presentation.

Conclusion: Performing ultrasonography screening earlier than 38 weeks of PMA caused unnecessary subsequent ultrasonography and overtreatment. Breech presentation was not a risk factor for DDH in preterm infants. However, breech presentation could increase the risk of minor abnormal findings at the 1st ultrasonography compared to nonbreech presentation, which resolved spontaneously. The etiology and risk factors for DDH in preterm infants are somewhat different from those for DDH in term infants.

Citing Articles

Refining Risk Factors for Developmental Dysplasia of the Hip in Neonates: A Cross-Sectional Study in a Tertiary Referral Center.

Kamali Hakim P, Mehdizadeh M, Zeinalkhani F, Rouzbahani A, Zeinalkhani H, Rajabi H Med J Islam Repub Iran. 2024; 38:68.

PMID: 39399627 PMC: 11469733. DOI: 10.47176/mjiri.38.68.

The diagnostic value of artificial intelligence-assisted imaging for developmental dysplasia of the hip: a systematic review and meta-analysis.

Chen M, Cai R, Zhang A, Chi X, Qian J J Orthop Surg Res. 2024; 19(1):522.

PMID: 39210407 PMC: 11360681. DOI: 10.1186/s13018-024-05003-4.

Globally inconsistent: Countries with top health indices erratic developmental hip dysplasia screening protocols.

Zusman N, Castaneda P, Goldstein R J Child Orthop. 2024; 18(4):393-398.

PMID: 39100982 PMC: 11295378. DOI: 10.1177/18632521241229978.

Extra-articular blocking technique for acetabular bone defect reconstruction.

Xu Z, Cheng Z, Li J, Zhang Y Ann Jt. 2024; 9:2.

PMID: 38529298 PMC: 10929398. DOI: 10.21037/aoj-23-14.

Length of treatment and ultrasound timing in infants with developmental dysplasia of the hip.

Dragonas C, Kottaridou E, Vampertzis T, Abbakr L, Taha N, Manoukian D Eur J Orthop Surg Traumatol. 2023; 34(2):1079-1086.

PMID: 37934277 DOI: 10.1007/s00590-023-03771-z.

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