Ηip dysplasia in children with spina bifida after prenatal surgical closure

To determine the prevalence of neonatal hip dysplasia in children with spina bifida after prenatal surgical closure and examine its association with functional level and preterm birth.

We conducted a retrospective analysis of prospectively collected standardized registry data from a tertiary specialized centre providing comprehensive spina bifida diagnosis, treatment, and follow-up. Standardized hip ultrasound according to the Graf method was performed as part of a protocolized clinical pathway after prenatal surgery, within the first week of life corrected for preterm birth. The primary outcome was the prevalence of hip dysplasia at the initial ultrasound. Associations between hip status, functional level, and gestational age were assessed using Spearman's rank correlation.

A total of 212 children (101 males, 111 females) underwent prenatal surgical closure between 1st January 2011 and 30th August 2022; 168 children (336 hips) had available neonatal ultrasound data and were included in the analysis. Preterm birth was present in 138 (82%) of 168 children, including 99 (59%) born late preterm, 35 (21%) born very preterm, and four (2%) born extremely preterm. At the initial ultrasound, 286 (85%) of 336 hips were mature, 33 (9.8%) were immature, and 17 (5.1%) were dysplastic. Worse hip status was weakly associated with a higher functional level (r = -0.243; p < 0.001), whereas no significant association was found between hip dysplasia and preterm birth (p = 0.080).

The prevalence of neonatal hip dysplasia in children with spina bifida after prenatal surgical closure was within the range reported for the general population.