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A case-control study of congenital hip dislocation
A Gunther1, S J Smith, P V Maynard
1Department of Public Health Medicine & Epidemiology, University of Nottingham Medical School, Queen's Medical Centre.
Insights
Mothers who have had multiple pregnancies showed a reduced risk of congenital dislocation of the hip (CDH). Breech birth and Cesarean delivery were associated with a higher risk of CDH.
Area of Science:
- Orthopedics
- Epidemiology
- Public Health
Background:
- Congenital dislocation of the hip (CDH) is a condition requiring identification of risk factors.
- Understanding epidemiological factors can aid in early detection and prevention strategies for CDH.
Purpose of the Study:
- To investigate epidemiological factors associated with congenital dislocation of the hip (CDH).
- To identify maternal and delivery-related risk factors for CDH.
Main Methods:
- Case-control study design involving 81 CDH cases and matched controls.
- Inclusion of a third group of 124 subjects from a Hip Instability Clinic.
- Data collection from obstetric records, focusing on maternal history and delivery methods.
Main Results:
- Multiparous and multigravidae mothers had a statistically significant reduced risk of CDH (RR 0.53-0.55).
- Increased risk of CDH was observed in babies born via Cesarean section or in breech presentation.
- A family history of CDH was more prevalent in confirmed CDH cases compared to normal controls.
Conclusions:
- Maternal parity is a significant protective factor against CDH.
- Delivery method (Cesarean, breech) and family history are important risk factors for CDH.
- Further research into these epidemiological factors can inform clinical practice and public health initiatives for CDH.
Abstract:
In this study we have investigated various epidemiological factors which may be related to congenital dislocation of the hip (CDH). Eighty-one cases born during the period 1st January 1988 to 31st August 1990, with four matched controls per case, were identified from consultants' records held at the Queen's Medical Centre and City Hospital, Nottingham. One hundred and twenty-four subjects who were referred to a new Hip Instability Clinic with suspected CDH, but not diagnosed or treated for CDH, were also included as a third group. Information about the mother's pregnancy, previous medical history and family history was collected from obstetric records kept at the two hospitals. Multigravidae and similarly multiparous women had a statistically significantly reduced risk of having a baby with CDH. The relative risks were 0.55 (95% confidence interval 0.33, 0.93) and 0.53 (95% confidence interval 0.31, 0.91) respectively. The method of delivery was also of importance. Babies born by Caesarean section or in breech position had an increased risk of CDH which was statistically significant. Using addition clinical information obtained from subjects attending the Hip Instability Clinic we also found that cases were more likely to have a family history of CDH than subjects who were screened for CDH but found to be normal.