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Association between timing and duration of breech presentation during pregnancy and developmental dysplasia of the
Annemieke Konijnendijk1, Ellen Vrugteveen2, Brenda Voorthuis2
1Department of Biomedical Signals and Systems, 3230University of Twente, Enschede, The Netherlands.
Insights
Breech presentation after 37 weeks gestation significantly increases the risk of developmental dysplasia of the hip (DDH) in infants. Longer breech duration further elevates this risk, highlighting the importance of timely interventions.
Area of Science:
- Pediatrics
- Orthopedics
- Obstetrics
Background:
- Developmental dysplasia of the hip (DDH) is a common pediatric condition.
- Breech presentation is a known risk factor for DDH, but the impact of timing and duration requires further clarification.
Purpose of the Study:
- To investigate the association between the timing and duration of breech presentation during pregnancy and the risk of developing DDH.
Main Methods:
- A case-control study comparing 191 children with DDH (aged ≤3 years) to 209 healthy controls.
- Data collected via online parent self-report questionnaires on pregnancy exposures and outcomes.
Main Results:
- Breech presentation after 30 weeks gestation doubled DDH risk (OR 2.01).
- Risk increased with duration: 5-8 weeks (OR 2.65), 9-12 weeks (OR 3.63).
- Breech presentation at or after 37 weeks significantly elevated DDH risk (OR 3.24, adjusted OR 3.33).
Conclusions:
- Late breech presentation (after 37 weeks) is a strong predictor of DDH.
- The duration of late breech presentation correlates with increased DDH risk.
- These findings underscore the need for monitoring and potential interventions for late breech presentations.
Abstract:
This case-control study investigated the association between timing and duration of breech presentation in pregnancy and developmental dysplasia of the hip (DDH). Children with DDH aged 3 years or younger (n = 191) were compared with healthy controls (n = 209). Data on outcome, exposure and, covariates were collected using a parents' self-report online questionnaire. Term children with breech presentation at one or more check-ups after 30.0 weeks gestation had a twofold higher risk of developing DDH compared to children who had never presented in breech (OR 2.01; 95% CI [1.28, 3.15]). The strength of the association increased with duration of breech presentation (5-8 weeks: OR 2.65; 95% CI [1.36, 5.18]; 9-12 weeks: OR 3.63; 95% CI [1.82, 7.24]). Children who had presented in breech at least once in gestational period 37.0-birth had a 3.24 (95% CI [1.86, 5.65]) times higher risk of DDH, whereas the risk for children with breech presentation in gestational period 30.0-36.6 only was not increased. Also after adjusting for confounders, children who had presented in breech after gestational week 37.0-birth had a more than threefold higher risk of DDH (OR 3.33; 95% CI [1.81, 6.13]) compared to children who were never in breech or in gestational period 30.0-36.6 only.
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