Jacobsen Kaya K, Kristiansen Hege, Gundersen Trude, Lie Stein Atle, Rosendahl Karen, Laborie Lene B
Department of Orthopedic Surgery, District General Hospital of Førde, Førde, Norway.
Department of Clinical Medicine, University of Bergen, Bergen, Norway.
Bone Joint J. 2025 Jul 1;107-B(7):761-768. doi: 10.1302/0301-620X.107B7.BJJ-2024-1555.R1.
Developmental dysplasia of the hip (DDH) is a congenital disorder with several assumed risk factors, including breech presentation, female sex, and familial predisposition. Although several of these risk factors are included in national screening programmes, delayed diagnoses of DDH still occur. The aim of this study was to examine the prevalence of these and other risk factors in order to improve the current screening programmes.
This study used data from the Norwegian Mother, Father, and Child Cohort Study (MoBa) and the Medical Birth Registry of Norway (MBRN). We used descriptive statistics and logistic regression analyses. Children with cerebral palsy, syndromic disorders, or developmental delay were excluded from the study.
A total of 107,194 children were included, with parents reporting using questionnaires if their child had a diagnosis of, or treatment for, DDH. A total of 3,460 children (3.2%) in MoBa had a diagnosis of DDH, with 1,453 (1.4%) being treated for DDH. Statistically significant risk factors included female sex, breech presentation, and pes equinovarus, whereas plural births and maternal diabetes were protective factors for DDH. Having a Caesarean section did not increase the prevalence of DDH.
We were able to confirm previously proposed risk factors such as breech presentation and female sex, whereas other variables such as plural births and Caesarean section were not found to be risk factors. However, regression analysis suggested that there are additional factors which affect the prevalence of DDH. These could be both environmental and genetic factors, highlighting the need for further research on DDH to improve the current screening programmes.
发育性髋关节发育不良(DDH)是一种先天性疾病,有多种假定的风险因素,包括臀位分娩、女性性别和家族易感性。尽管其中一些风险因素已被纳入国家筛查计划,但DDH的延迟诊断仍有发生。本研究的目的是检查这些及其他风险因素的患病率,以改进当前的筛查计划。
本研究使用了挪威母亲、父亲和儿童队列研究(MoBa)以及挪威医学出生登记处(MBRN)的数据。我们使用了描述性统计和逻辑回归分析。患有脑瘫、综合征性疾病或发育迟缓的儿童被排除在研究之外。
总共纳入了107,194名儿童,其父母通过问卷报告孩子是否被诊断为DDH或接受过DDH治疗。MoBa中共有3,460名儿童(3.2%)被诊断为DDH,其中1,453名(1.4%)接受了DDH治疗。具有统计学意义的风险因素包括女性性别、臀位分娩和马蹄内翻足,而多胞胎和母亲糖尿病是DDH的保护因素。剖宫产并未增加DDH的患病率。
我们能够证实先前提出的风险因素,如臀位分娩和女性性别,而多胞胎和剖宫产等其他变量未被发现是风险因素。然而,回归分析表明还有其他因素影响DDH的患病率。这些因素可能是环境和遗传因素,这凸显了对DDH进行进一步研究以改进当前筛查计划的必要性。