Hanratty Charlotte, Thyagarajan Balamurugan, Clarke Nicholas M, Aarvold Alexander
University of Southampton, Southampton, UK.
Princess Anne Maternity Hospital, University Hospital Southampton, Southampton, UK.
Indian J Orthop. 2021 Aug 30;55(6):1515-1522. doi: 10.1007/s43465-021-00465-8. eCollection 2020 Dec.
Developmental Dysplasia of the Hip (DDH) has been linked to high birth weight and packaging disorders, though the evidence is limited. This has implications on screening strategies. The aim of this study was to establish whether birth weight was truly associated with the incidence of DDH.
This cohort study analysed the birth weights of all babies born at our institution over a 24 month period, between 01/01/2017 and 01/01/2019. Babies with DDH and those without DDH were compared. Babies were excluded if born before 38 weeks, had incomplete data or were a non-singleton pregnancy. Sub-analysis was performed for DDH severity (dysplastic versus subluxed/dislocated hips), breech presentation, gestational age, gender and ethnicity. Statistical analysis was performed using SPSS.
There were 10,113 babies born at our institution during the selected timeframe, of which 884 were excluded for prematurity, 336 for being non-singleton and 19 for incomplete data. This left 8874 for analysis, of which 95 babies had confirmed DDH. Both the Non-DDH and DDH data sets had normal distribution (Shapiro-Wilkes, = 0.308 and 0.629, respectively), with mean birth weights of 3477.7 g with DDH and 3492.8 g without DDH. No difference in birth weight was found (Independent test, = 0.789). Females had a lower birth weight than males (3293.1 g versus 3416.6 g ( < 0.001)) yet have a higher incidence of DDH (ratio 6:1 in this dataset). No significant difference was found between birth weights of females with and without DDH ( = 0.068), nor between males with and without DDH ( = 0.513). There were no significant differences in birth weights even when only displaced hips were analysed ( = 0.543), nor according to breech presentation ( = 0.8). Longer gestation babies weighed more ( < 0.00001), yet showed no increase in DDH incidence ( = 0.64).
This study discredits the belief that DDH may be related to higher birth weight, thus casting doubt on the link to DDH being a packaging problem in utero. This, therefore, allows future research to prioritise the investigation of alternative aetiologies.
尽管证据有限，但髋关节发育不良（DDH）已被认为与高出生体重及分娩相关疾病有关。这对筛查策略具有重要意义。本研究的目的是确定出生体重是否真的与DDH的发病率相关。
这项队列研究分析了2017年1月1日至2019年1月1日期间在我们机构出生的所有婴儿的出生体重。比较了患有DDH的婴儿和未患有DDH的婴儿。如果婴儿在38周前出生、数据不完整或为非单胎妊娠，则将其排除。对DDH严重程度（髋关节发育不良与半脱位/脱位）、臀位、胎龄、性别和种族进行了亚组分析。使用SPSS进行统计分析。
在选定的时间段内，我们机构共出生10113名婴儿，其中884名因早产被排除，336名因非单胎被排除，19名因数据不完整被排除。剩余8874名婴儿用于分析，其中95名婴儿确诊为DDH。非DDH组和DDH组数据集均呈正态分布（Shapiro-Wilkes检验，分别为0.308和0.629），DDH组婴儿的平均出生体重为3477.7克，非DDH组为3492.8克。未发现出生体重有差异（独立样本t检验，P = 0.789）。女性出生体重低于男性（3293.1克对3416.6克（P < 0.001）），但DDH发病率更高（该数据集中比例为6:1）。患有DDH和未患有DDH的女性之间出生体重无显著差异（P = 0.068），男性之间也无显著差异（P = 0.513）。即使仅分析脱位髋关节的婴儿，出生体重也无显著差异（P = 0.543），根据臀位分析也无显著差异（P = 0.8）。胎龄较长的婴儿体重更重（P < 0.00001），但DDH发病率未增加（P = 0.64）。
本研究对DDH可能与较高出生体重有关的观点提出了质疑，从而对DDH与子宫内分娩相关问题之间存在联系这一观点产生了怀疑。因此，这使得未来的研究能够优先调查其他病因。
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