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Relative Risk and Incidence for Developmental Dysplasia of the Hip
Virginie Pollet1, Vanessa Percy2, Heather J Prior3
1Erasmus Medical Center, Sophia Children's Hospital, Rotterdam, The Netherlands.
Insights
Developmental dysplasia of the hip (DDH) affects 6.6/1000 newborns. Female, first-born infants with clubfoot or breech presentation have higher risks, with rural births presenting later.
Area of Science:
- Orthopedics
- Pediatrics
- Public Health
Background:
- Developmental dysplasia of the hip (DDH) is a condition affecting hip joint development in infants.
- Early detection and intervention are crucial for optimal outcomes in DDH management.
- Understanding incidence and risk factors in populations without universal screening is essential for public health strategies.
Purpose of the Study:
- To determine the incidence of DDH in a contemporary population.
- To identify associated risk factors for DDH in newborns.
- To analyze regional variations in DDH presentation and diagnosis.
Main Methods:
- Retrospective cohort study using health administrative data (1995-2012) and imaging reviews (2004-2012).
- Inclusion of all live births in Manitoba, Canada.
- Statistical analysis using chi-squared tests to assess relative risks of identified factors.
Main Results:
- Overall DDH incidence was 6.6 per 1000 newborns; late-presenting DDH occurred in 2.2 per 1000.
- Significant risk factors included female sex, first-born status, breech presentation, and clubfoot deformity.
- Children in rural Northern/Central Manitoba had later DDH presentation compared to urban counterparts (P < .0001).
Conclusions:
- The study highlights the continued incidence of DDH and identifies key risk factors.
- Regional disparities in presentation age suggest potential barriers to early detection in rural areas.
- Enhanced awareness of risk factors and regional differences is needed at well-baby clinics for improved early DDH detection.
Objective:
To determine the incidence and associated risk factors of developmental dysplasia of the hip (DDH) in a modern population without universal screening.
Study Design:
Children with DDH were identified from the Manitoba Centre for Health Policy's Data Repository by the use of International Classification of Diseases diagnosis codes as well as physician billing tariffs for surgical procedures for DDH for all children born between 1995 and 2012. To identify the outpatient-treated patients, ultrasound scans and radiographic imaging for DDH were reviewed for 2004-2012. Overall incidence was calculated on the basis of birth rate for the province per year. Relative risks of sex, first born, breech position, clubfoot deformity, multiple gestations, as well as regional health areas were analyzed with χ2 tests.
Results:
We identified 1716 cases of DDH of 258 499 newborns. The incidence of DDH was calculated at 6.6/1000 newborns. Late-presenting DDH was detected in 2.2/1000 newborns. Female first-born children, clubfoot deformity, and breech position were associated significantly with an increased risk. Children with DDH born in rural areas of the Northern and Central part of Manitoba presented at a later age than those who are born in the urban areas (P < .0001) CONCLUSION: This study shows the need for improved early detection and awareness at well-baby clinics of risk factors and regional differences for DDH.
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