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Descriptive epidemiology of idiopathic clubfoot

Martha M Werler1, Mahsa M Yazdy, Allen A Mitchell

  • 1Slone Epidemiology Center at Boston University, Boston, MA 02215, USA. werler@bu.edu

American Journal of Medical Genetics. Part A
|May 21, 2013
PubMed

Insights

This study found that male infants, first-time mothers, and mothers with a high body mass index (BMI) have an increased risk of clubfoot. Specific pregnancy complications also elevate this risk, suggesting obesity may play a role in clubfoot development.

Area of Science:

  • Pediatric Orthopedics
  • Medical Genetics
  • Epidemiology

Background:

  • Clubfoot is a common congenital foot deformity with an unknown etiology.
  • Previous research on risk factors has yielded inconsistent results, except for male sex and primiparity.
  • Hypotheses include fetal constraint, genetic factors, and vascular disruption.

Purpose of the Study:

  • To investigate sociodemographic and pregnancy-related risk factors for clubfoot.
  • To explore potential pathogenetic pathways including fetal constraint, inheritance, and vascular disruption.

Main Methods:

  • Population-based case-control study in North Carolina, Massachusetts, and New York (2007-2011).
  • Interviewed mothers of 677 clubfoot cases and 2,037 controls within one year of delivery.
  • Collected data on maternal and infant factors, including maternal BMI and pregnancy complications.

Main Results:

  • Male infants (OR: 2.7) and those born to primiparous mothers (OR: 1.4) or mothers with BMI ≥30 kg/m² (OR: 1.4) had increased odds of clubfoot.
  • Pregnancy complications like oligohydramnios, breech delivery, and early amniocentesis were associated with higher odds of clubfoot.
  • Associations between high BMI and clubfoot were more pronounced in cases with markers of fetal constraint, inheritance, or vascular disruption.

Conclusions:

  • Male sex, primiparity, and maternal obesity are significant risk factors for clubfoot.
  • Certain pregnancy complications are associated with increased clubfoot risk.
  • Obesity-related pathogenetic factors may contribute to the development of clubfoot, particularly when combined with other risk factors.

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