Frequency of Risk Factors for Developmental Dysplasia of the Hip in Patients Presenting to a Tertiary Care Hospital: Risk Factors for Developmental Dysplasia of the Hip

Muhammad Saqib; Abdul Munaf Saud; Aman Ullah Khan Kakar; Syed Abdur Rub Abidi; Muhammad Shoaib Saleem; Zia Ullah; Amina Gul Shehzar Khan

doi:10.54393/pjhs.v6i4.2839

Authors

Muhammad Saqib Department of Orthopedics, Gajju Khan Medical College, Bacha Khan Medical Complex, Swabi, Pakistan
Abdul Munaf Saud Department of Orthopedic Surgery, Bahawal Victoria Hospital, Bahawalpur, Pakistan
Aman Ullah Khan Kakar Department of Orthopedic Surgery, Bolan Medical College, Quetta, Pakistan
Syed Abdur Rub Abidi Department of Orthopedic Surgery, Jinnah Medical and Dental College, Karachi, Pakistan
Muhammad Shoaib Saleem Department of Orthopedics, Amina Inayat Medical College, Kishwar Fazal Teaching Hospital, Lahore, Pakistan
Zia Ullah Department of Orthopedics, Khalifa Gul Nawaz Hospital, Bannu Medical College, Bannu, Pakistan
Amina Gul Shehzar Khan Department of Orthopedics, Ayub Teaching Hospital, Abbottabad, Pakistan

DOI:

https://doi.org/10.54393/pjhs.v6i4.2839

Keywords:

DDH, Low Birth Weight, Multiple Pregnancies, Breech Presentation

Abstract

Developmental dysplasia of the hip (DDH) involves abnormal hip joint development and is influenced by several perinatal risk factors. Early diagnosis is essential for optimal management. Objective: To evaluate the frequency of DDH-associated risk factors and their statistical associations. Methods: A cross-sectional study was conducted at Quaid-E-Azam Medical College, Bahawalpur, from January to August 2024. A total of 153 DDH patients were included. Risk factors such as gender, gestational age, birth weight, mode of delivery, breech presentation, oligohydramnios, multiple pregnancies, firstborn status, family history, and maternal complications were documented. Associations were analyzed using chi-square tests (p<0.05). Results: Of the 153 patients, 77 (50.3%) were male and 76 (49.7%) female. Term births were predominant (75.2%), and 19.6% had low birth weight. Breech presentation was seen in 13.7%, and oligohydramnios in 16.3%. Cesarean section accounted for 66.7% of deliveries, with no significant association with breech presentation (p=1.000). A significant association was found between multiple pregnancies and low birth weight, as all multiple births had low birth weight infants (p=0.000). No significant associations were found for gender, oligohydramnios, firstborn status, or family history. Conclusions: It was concluded that multiple pregnancies and resulting low birth weight showed a significant association with DDH. Other risk factors, including breech presentation and oligohydramnios, demonstrated no significant correlation. Focused DDH screening is recommended in infants from multiple gestations with low birth weight to ensure early detection and intervention.

References

Murgai RR, Harris LR, Choi PD, Goldstein RY. Socioeconomic Risk Factors for Poor Outcomes of Developmental Dysplasia of the Hip. The Journal of Pediatrics. 2019 Aug; 211: 159-63. doi: 10.1016/j.jpeds.2019.04.029.

Chavoshi M, Soltani G, Zargar SS, Wyles CC, Kremers HM, Rouzrokh P. Diagnostic Performance of Clinical Examination Versus Ultrasonography in the Detection of Developmental Dysplasia of Hip: A Systematic Review and Meta-Analysis. Archives of Bone and Joint Surgery. 2022 May; 10(5): 403.

Pulik Ł, Romaniuk K, Sibilska A, Jedynak A, Tołowiński I, Kumięga P et al. Impact of Multiple Factors on the Incidence of Developmental Dysplasia of the Hip. 2021. doi: 10.21203/rs.3.rs-1037297/v1.

Roposch A, Protopapa E, Malaga-Shaw O, Gelfer Y, Humphries P, Ridout D et al. Predicting Developmental Dysplasia of the Hip in At-Risk Newborns. BioMed Central Musculoskeletal Disorders. 2020 Dec; 21: 1-8. doi: 10.1186/s12891-020-03454-4.

De Hundt M, Vlemmix F, Bais JM, Hutton EK, De Groot CJ, Mol BW et al. Risk Factors for Developmental Dysplasia of the Hip: A Meta-Analysis. European Journal of Obstetrics and Gynecology and Reproductive Biology. 2012 Nov; 165(1): 8-17. doi: 10.1016/j.ejogrb.2012.06.030.

Motta GG, Chiovatto AR, Chiovatto ED, Luís Duarte M, Rodrigues NV, Iared W. Prevalence of Developmental Dysplasia of the Hip in a Maternity Hospital in São Paulo, Brazil. Revista brasileira de ortopedia. 2021 Dec; 56(5): 664-70. doi: 10.1055/s-0041-1736407.

Sezer C, Unlu S, Demirkale I, Altay M, Kapicioglu S, Bozkurt M. Prevalence of Developmental Dysplasia of the Hip in Preterm Infants with Maternal Risk Factors. Journal of Children's Orthopedics. 2013 Oct; 7(4): 257-61. doi: 10.1007/s11832-013-0498-3.

Sharpe P, Mulpuri K, Chan A, Cundy P. Differences in Risk Factors Between Early and Late Diagnosed Developmental Dysplasia of the Hip. Archives of Disease in Childhood-Fetal and Neonatal Edition. 2006 May; 91(3): F158-62. doi: 10.1136/adc.2004.070870.

Nelson SE, DeFrancesco CJ, Sankar WN. Operative Reduction for Developmental Dysplasia of the Hip: Epidemiology Over 16 Years. Journal of Pediatric Orthopedics. 2019 Apr; 39(4): e272-7. doi: 10.1097/BPO.0000000000001292.

Fan ZZ, Yan YB, Sha J, Xu HF, Li C, Liu ZC et al. Risk Factors for Misdiagnosis in Children with Developmental Dysplasia of the Hip: A Retrospective Single-Centre Study. British Medical Journal Pediatrics Open. 2023 Jun; 7(1): e001909. doi: 10.1136/bmjpo-2023-001909.

Malyavko A, Quan T, Howard PG, Recarey M, Manzi JE, Tabaie S. Racial Disparities in Postoperative Outcomes Following Operative Management of Pediatric Developmental Dysplasia of the Hip. Journal of Pediatric Orthopedics. 2022 May; 42(5): e403-8. doi: 10.1097/BPO.0000000000002102.

Harsanyi S, Zamborsky R, Krajciova L, Kokavec M, Danisovic L. Developmental Dysplasia of the Hip: A Review of Etiopathogenesis, Risk Factors, and Genetic Aspects. Medicina. 2020 Mar; 56(4): 153. doi: 10.3390/medicina56040153.

Zeb J, Hayat S, Afzal I, Haq SN, Shoaib M, Zeb M et al. Frequency of Risk factors for Developmental Dysplasia of Hip (DDH) in patients presenting to a Tertiary Care Hospital. Journal of Pakistan Orthopedic Association. 2022; 34(04): 163-5.

Xiao H, Tang Y, Su Y. Risk Factors of Developmental Dysplasia of the Hip in A Single Clinical Center. Scientific Reports. 2022 Nov; 12(1): 19461. doi: 10.1038/s41598-022-24025-8.

Kural B, Devecioglu E, Gökçay G, Eren T, Yılmazbaş P, Gökçay I. P129 Risk Factors for Developmental Dysplasia of the Hip: 10-Year Experience. 2019; 104(3). doi: 10.1136/archdischild-2019-epa.484.

Lankinen V, Helminen M, Bakti K, Välipakka J, Laivuori H, Hyvärinen A. Known Risk Factors of the Developmental Dysplasia of the Hip Predicting More Severe Clinical Presentation and Failure of Pavlik Harness Treatment. BioMed Central Pediatrics. 2023 Mar; 23(1): 148. doi: 10.1186/s12887-023-03935-0.

Ionescu A, Dragomirescu MC, Herdea A, Ulici A. Developmental Dysplasia of the Hip: How Many Risk Factors Are Needed? Children. 2023 May; 10(6): 968. doi: 10.3390/children10060968.

Ghaznavi A, Mohammadpour M, Noori A, Rajei M. Geographical Distribution of Developmental Dysplasia of the Hip: A Brief Epidemiological Study of Iran. Medical Journal of the Islamic Republic of Iran. 2023 Feb; 37: 13. doi: 10.47176/mjiri.37.13.

Hakim PK, Mehdizadeh M, Zeinalkhani F, Rouzbahani AK, Zeinalkhani H, Rajabi H et al. Refining Risk Factors for Developmental Dysplasia of the Hip in Neonates: A Cross-Sectional Study in a Tertiary Referral Centre. Medical Journal of the Islamic Republic of Iran. 2024 Jun; 38: 68. doi: 10.47176/mjiri.38.68.

Kuitunen I, Uimonen MM, Haapanen M, Sund R, Helenius I, Ponkilainen VT. Incidence of Neonatal Developmental Dysplasia of the Hip and Late Detection Rates Based on Screening Strategy: A Systematic Review and Meta-Analysis. Journal of the American Medical Association Network Open. 2022 Aug; 5(8): e2227638-. doi: 10.1001/jamanetworkopen.2022.27638.