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Updated: Oct 7, 2025
In Vivo Quantification of Hip Arthrokinematics during Dynamic Weight-bearing Activities using Dual Fluoroscopy
Published on: July 2, 2021
There is No Link Between Birth Weight and Developmental Dysplasia of the Hip
Charlotte Hanratty1, Balamurugan Thyagarajan2, Nicholas M Clarke1
1University of Southampton, Southampton, UK.
Insights
This study found no association between higher birth weight and Developmental Dysplasia of the Hip (DDH). Findings suggest DDH is not a packaging problem, prompting research into other causes.
Area of Science:
- Orthopedics
- Pediatrics
- Developmental Biology
Background:
- Developmental Dysplasia of the Hip (DDH) has been anecdotally linked to high birth weight and intrauterine packaging disorders.
- Limited evidence exists to support these associations, impacting current screening strategies for DDH.
Purpose of the Study:
- To investigate the association between birth weight and the incidence of Developmental Dysplasia of the Hip (DDH).
- To determine if birth weight is a significant risk factor for DDH.
Main Methods:
- A cohort study analyzed birth weights of 8874 infants born between 2017-2019.
- Infants with DDH (n=95) were compared to those without DDH, excluding preterm, non-singleton, and incomplete data cases.
- Sub-analyses considered DDH severity, breech presentation, gestational age, gender, and ethnicity.
Main Results:
- No statistically significant difference in mean birth weight was observed between infants with DDH (3477.7 g) and those without (3492.8 g).
- Birth weight did not correlate with DDH incidence across various subgroups, including gender and breech presentation.
- While females had lower birth weights and higher DDH incidence, birth weight itself was not a differentiating factor for DDH in females or males.
Conclusions:
- The study refutes the hypothesis that higher birth weight is a significant risk factor for Developmental Dysplasia of the Hip (DDH).
- Findings challenge the notion of DDH as a consequence of intrauterine packaging issues related to size.
- Further research should prioritize exploring alternative etiologies for DDH.
Aims:
Developmental Dysplasia of the Hip (DDH) has been linked to high birth weight and packaging disorders, though the evidence is limited. This has implications on screening strategies. The aim of this study was to establish whether birth weight was truly associated with the incidence of DDH.
Patients And Methods:
This cohort study analysed the birth weights of all babies born at our institution over a 24 month period, between 01/01/2017 and 01/01/2019. Babies with DDH and those without DDH were compared. Babies were excluded if born before 38 weeks, had incomplete data or were a non-singleton pregnancy. Sub-analysis was performed for DDH severity (dysplastic versus subluxed/dislocated hips), breech presentation, gestational age, gender and ethnicity. Statistical analysis was performed using SPSS.
Results:
There were 10,113 babies born at our institution during the selected timeframe, of which 884 were excluded for prematurity, 336 for being non-singleton and 19 for incomplete data. This left 8874 for analysis, of which 95 babies had confirmed DDH. Both the Non-DDH and DDH data sets had normal distribution (Shapiro-Wilkes, p = 0.308 and 0.629, respectively), with mean birth weights of 3477.7 g with DDH and 3492.8 g without DDH. No difference in birth weight was found (Independent T test, p = 0.789). Females had a lower birth weight than males (3293.1 g versus 3416.6 g (p < 0.001)) yet have a higher incidence of DDH (ratio 6:1 in this dataset). No significant difference was found between birth weights of females with and without DDH (p = 0.068), nor between males with and without DDH (p = 0.513). There were no significant differences in birth weights even when only displaced hips were analysed (p = 0.543), nor according to breech presentation (p = 0.8). Longer gestation babies weighed more (p < 0.00001), yet showed no increase in DDH incidence (p = 0.64).
Conclusion:
This study discredits the belief that DDH may be related to higher birth weight, thus casting doubt on the link to DDH being a packaging problem in utero. This, therefore, allows future research to prioritise the investigation of alternative aetiologies.
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