Κατεύθυνση Επιδημιολογία-Μεθοδολογία έρευνας στις βιοϊατρικές επιστήμες, την κλινική πράξη και τη δημόσια υγεία
Library of the School of Health Sciences

2022-12-01

2022

Tirta Maria

Βασιλική Μπενέτου, Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Παγώνα Λάγιου, Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Στεφάνια Παπαθεοδώρου, Λέκτορας, Σχολή Δημόσιας Υγείας, Harvard T.H. Chan

Παράγοντες που σχετίζονται με την εμφάνιση της αναπτυξιακής δυσπλασίας του ισχίου

Greek

Investigation of potential association of several factors with the occurrence of Developmental dysplasia of the hip

Background: Developmental dysplasia of the hip (DDH) is the most common paediatric hip disorder and occurs due to an abnormal hip development. Presentation varies from minor hip instability to frank dislocation. When left untreated or missed during early screening, DDH can lead to debilitating long term issues, including earlyonset osteoarthritis of the hip, pain, limping, and the need for a total hip replacement in early adulthood. Multifactorial in nature, a combination of genetic, environmental, and mechanical factors play a role in its etiology.

Objectives: To investigate the potential association of several factors with the occurrence of DDH, in a large sample of Greek infants.

Methods: A retrospective cohort study was conducted at the Department of Pediatric Orthopaedics and Traumatology at the «Agia Sofia» Children’s University Hospital. The data derived from the hospital records kept in the context of the Newborn Hip Screening Programme, covering a time period of almost five years, from September 2017 until April 2022. The presence of DDH was assessed by the use of the Graf ultrasonography method. Univariate and multivariate logistic regression analyses were performed to examine the association between several factors and DDH presence.

Results: From 3306 screened newborns (6612 hips), 3229 infants had mature/immature hips but appropriate for age (Graf type I, IIa) and 77 were found pathological (Graf type IIb, IIc, D, III and IV) (Prevalence of DHH: 2.3%). Breech presentation [(Odds Ratio (OR): 2.85; 95% Confidence Intervals (95%CI): 1.55-5.27), family history of DDH (OR: 3.59; 95% CI: 1.89-6.83) and female sex (OR: 4.57; 95%CI: 2.49-8.37) significantly increased the risk of DDH. Full-term infants with normal/high birthweight (OR: 5.17; 95%CI:1.85-14.45), full-term infants with low birthweight (OR:1.83; 95% CI:0.33-10.24) and premature infants with normal birthweight (OR: 2.54; 95% CI: 0.56-11.55) had all higher risk of DDH compared to premature infants with low birthweight, although the last two comparisons did not reach statistical significance. Firstborn child, and caesarean section were not associated with DDH. Infants with at least one risk factor had a fivefold risk of DDH compared to those with no risk factors (OR 4.77; 95% CI: 2.44-9.30).

Conclusion: The study confirms the significant association of certain factors/characteristics with DDH and highlights the importance of being alert in order to timely identify newborns at higher risk of DDH.

Health Sciences

Developmental Dysplasia Hip, Risk factors, Protective factors, Screening Program, Graf Ultrasonography

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Yes

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File access is restricted until 2024-12-02.

https://pergamos.lib.uoa.gr/uoa/dl/object/3252863