Sia Ung, Chen Hui Wen, Lee Wei Chun, Kao Hsuan Kai, Yang Wen E, Chang Chia Hsieh
Department of Orthopaedics, Sarawak General Hospital, Kuching, Malaysia.
Department of Pediatrics, Taipei Tzu-Chi Hospital, New Taipei, Taiwan.
Pediatr Neonatol. 2025 Jul;66(4):334-338. doi: 10.1016/j.pedneo.2024.05.005. Epub 2024 Oct 19.
Babies born in winter have greater incidence of developmental dysplasia of the hip (DDH) and related surgeries. How weather conditions impact hip development and how screening program reacts weather issue remain unknown. This study tests a hypothesis that winter born babies have more newborn acetabular dysplasia and laxity that is responsible of later DDH.
Retrospective data from newborns who had hip ultrasonography in the first 3 days of life were analyzed. The Graf type IIc, III, IV (shallow acetabulum) and type D (laxity) were classified as abnormal. The association and risks of an abnormal hip were analyzed with gender, gestational age, fetal presentation, parity and external temperature of birth month and the last 3 months before birth using the Pearson chi-square test and logistic regression.
A total of 10962 newborns participated in hip ultrasound exams voluntarily in nurseries from 2016 to 2022. Distribution of babies with Graf type I, IIa, IIc, D, III/IV hips were 88.8%, 10%, 0.5%, 0.6%, and 0.1%, respectively. Female was the most significant factor for congenital shallow acetabulum (3.8x) and hip laxity (4x) compared to male (p < 0.001). Preterm babies had a borderline lower risk of abnormal hips (0.4x, p = 0.05). Winter season is not associated with newborn abnormal hips (p = 0.36, statistical power = 80%), but a positive correlation was noted between external temperature and incidence of abnormal hips (r = 0.62, p = 0.03). Cold weather does not have a direct internal effect in acetabular dysplasia or hip laxity at birth.
Babies who were born in winter were not associated with acetabular dysplasia and hip laxity at birth but had greater risks of late-diagnosed DDH and surgeries. The postnatal effects from weather should be addressed by a public awareness campaign, and hip screening may not be limited on the neonatal stage.
level III, diagnostic.
冬季出生的婴儿发生髋关节发育不良（DDH）及相关手术的几率更高。天气状况如何影响髋关节发育以及筛查项目如何应对天气问题仍不清楚。本研究检验了一个假设，即冬季出生的婴儿有更多的新生儿髋臼发育不良和松弛，这是导致后期DDH的原因。
分析了出生后前3天接受髋关节超声检查的新生儿的回顾性数据。Graf IIc型、III型、IV型（髋臼浅）和D型（松弛）被归类为异常。使用Pearson卡方检验和逻辑回归分析髋关节异常与性别、胎龄、胎位、产次以及出生月份和出生前最后3个月的外部温度之间的关联和风险。
2016年至2022年期间，共有10962名新生儿在托儿所自愿参加了髋关节超声检查。Graf I型、IIa型、IIc型、D型、III/IV型髋关节婴儿的分布分别为88.8%、10%、0.5%、0.6%和0.1%。与男性相比，女性是先天性髋臼浅（3.8倍）和髋关节松弛（4倍）的最显著因素（p < 0.001）。早产儿髋关节异常的风险略低（0.4倍，p = 0.05）。冬季与新生儿髋关节异常无关（p = 0.36，统计效能 = 80%），但外部温度与髋关节异常发生率之间存在正相关（r = 0.62，p = 0.03）。寒冷天气对出生时的髋臼发育不良或髋关节松弛没有直接的内在影响。
冬季出生的婴儿出生时与髋臼发育不良和髋关节松弛无关，但后期诊断为DDH及接受手术的风险更高。天气的产后影响应通过公众宣传活动来解决，髋关节筛查可能不应局限于新生儿阶段。
III级，诊断性。
