美国中西部（印第安纳州）发育性髋关节发育不良的人口统计学特征。
The demographics of developmental hip dysplasia in the Midwestern United States (Indiana).
作者信息
Loder Randall T, Shafer Cody
机构信息
Department of Orthopaedic Surgery, Indiana School of Medicine, Indiana University, Indianapolis, IN, USA,
出版信息
J Child Orthop. 2015 Feb;9(1):93-8. doi: 10.1007/s11832-015-0636-1. Epub 2015 Feb 19.
BACKGROUND
Today's society is much more mobile than in the past. This increased mobility has resulted in different marriage/parenting groups. We wished to study the demographics of developmental dysplasia of the hip (DDH) in our area and compare/contrast our findings with those in the literature and specifically look for new findings compared to previous studies.
METHODS
A retrospective review of all children with DDH from 2003 through 2012 was performed. The age at first visit, gestational age, pregnancy number, gender, race, and family history of DDH was collected. Statistical significance was a p-value < 0.05.
RESULTS
There were 424 children (363 girls, 61 boys). Ethnicity was White in 80.8 %, Hispanic in 13.8 %, Black in 4.0 %, and Indo-Malay and Indo-Mediterranean in 0.7 % each; 66.8 % were unilateral; 14.2 % had a positive family history. The average gestational age was 38.1 weeks; 94.4 % were full term. The child was vertex presentation in 67.6 % and breech in 32.4 %; 52.8 % were delivered vaginally and 47.2 % by Cesarean section. The child was the first-born in 48.3 %. When compared to the birth statistics of our state, there was a higher proportion of Whites and Hispanics with DDH, and a lower, but not inconsequential, proportion of Blacks (p = 0.0018).
CONCLUSION
Mixing of gene pools and infant carrying methods (lack of swaddling or marked abduction) occurring with societal change likely explains the higher than expected proportion of DDH amongst those of Hispanic ethnicity and a lower than expected, but not rare, proportion in those of African ancestry.
LEVEL OF EVIDENCE
Level IV-retrospective case series.
背景
当今社会的流动性比过去大得多。这种流动性的增加导致了不同的婚姻/育儿群体。我们希望研究我们地区发育性髋关节发育不良（DDH）的人口统计学特征，并将我们的研究结果与文献中的结果进行比较/对比，特别是寻找与以往研究相比的新发现。
方法
对2003年至2012年期间所有DDH患儿进行回顾性研究。收集首次就诊年龄、孕周、妊娠次数、性别、种族和DDH家族史。统计学显著性为p值<0.05。
结果
共有424名儿童（363名女孩，61名男孩）。种族分布为白人占80.8%，西班牙裔占13.8%，黑人占4.0%，印度-马来人和印度-地中海人各占0.7%；66.8%为单侧发病；14.2%有阳性家族史。平均孕周为38.1周；94.4%为足月产。胎儿头位分娩占67.6%，臀位分娩占32.4%；52.8%经阴道分娩，47.2%剖宫产。头胎占48.3%。与我们州的出生统计数据相比，患DDH的白人及西班牙裔比例较高，黑人比例较低，但并非微不足道（p = 0.0018）。
结论
社会变革导致的基因库混合和婴儿携带方式（缺乏襁褓或显著外展）可能解释了西班牙裔人群中DDH比例高于预期，而非洲裔人群中比例低于预期但并非罕见的现象。
证据级别
IV级——回顾性病例系列。
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