Motta Giovanna Galvão Braga, Chiovatto Alessandra Rodrigues Silva, Chiovatto Eduardo Davino, Duarte Márcio Luís, Rodrigues Natasha Vogel Majewski, Iared Wagner
Universidade Federal de São Paulo, Departamento de Saúde Baseada em Evidências, São Paulo, São Paulo, Brasil.
Centro de Aperfeiçoamento e Pesquisa em Ultrassonografia Prof. Dr. Giovanni Guido Cerri (DASA), Departamento de Ultrassonografia São Paulo, São Paulo, Brasil.
Rev Bras Ortop (Sao Paulo). 2021 Oct 28;56(5):664-670. doi: 10.1055/s-0041-1736407. eCollection 2021 Oct.
To evaluate the prevalence of developmental dysplasia of the hip (DDH), that is, hips classified as Graf type-IIc or higher, among a sample of the population of newborns aged from 0 to 3 days of life, and to correlate the findings with the main risk factors described in the literature. An observational, cross-sectional, prospective study on a sample of newborns at a Maternity Hospital School in the city of São Paulo, Brazil, to assess the prevalence of DDH diagnosed by the Graf method and verify its correlation with the risk factors. A total of 678 newborns underwent hip ultrasound (1,356 hips). The prevalence of DDH was of 5.46%. The logistic regression analysis showed odds ratios (ORs) with statistical significance for the following parameters: white ethnicity (OR = 2.561; 95% confidence interval [95%CI]: 1.07 to 6.11); multiparity (OR = 3.50; 95%CI: 1.62 to 7.38), female gender (OR = 4.95; 95%CI: 1.86 to 13.13); and breech presentation (OR = 2.03; 95%CI: 1,01 to 4.11). The prevalence of DDH in the sample was of 5.45% using ultrasound as a diagnostic method. This result is different from that of studies that assessed prevalence exclusively through physical examination (Ortolani maneuver). The main risk factors associated with a higher risk of developing DDH were newborns of the female gender, with breech presentation, firstborns, and of white ethnicity.
评估出生0至3天的新生儿样本中髋关节发育不良(DDH)(即Graf IIc型及以上分类的髋关节)的患病率,并将结果与文献中描述的主要风险因素相关联。 在巴西圣保罗市一家妇产医院学校对新生儿样本进行一项观察性、横断面、前瞻性研究,以评估通过Graf方法诊断的DDH患病率,并验证其与风险因素的相关性。 共有678名新生儿接受了髋关节超声检查(1356个髋关节)。DDH的患病率为5.46%。逻辑回归分析显示,以下参数的比值比(OR)具有统计学意义:白人种族(OR = 2.561;95%置信区间[95%CI]:1.07至6.11);多胎妊娠(OR = 3.50;95%CI:1.62至7.38),女性性别(OR = 4.95;95%CI:1.86至13.13);以及臀位(OR = 2.03;95%CI:1.01至4.11)。 使用超声作为诊断方法,样本中DDH的患病率为5.45%。这一结果与仅通过体格检查(奥尔托拉尼手法)评估患病率的研究结果不同。与发生DDH风险较高相关的主要风险因素是女性新生儿、臀位、头胎和白人种族。