Prevalence of Developmental Dysplasia of the Hip in a Maternity Hospital in São Paulo, Brazil^[*]

Abstract

Objective To evaluate the prevalence of developmental dysplasia of the hip (DDH), that is, hips classified as Graf type-IIc or higher, among a sample of the population of newborns aged from 0 to 3 days of life, and to correlate the findings with the main risk factors described in the literature.

Methods An observational, cross-sectional, prospective study on a sample of newborns at a Maternity Hospital School in the city of São Paulo, Brazil, to assess the prevalence of DDH diagnosed by the Graf method and verify its correlation with the risk factors.

Results A total of 678 newborns underwent hip ultrasound (1,356 hips). The prevalence of DDH was of 5.46%. The logistic regression analysis showed odds ratios (ORs) with statistical significance for the following parameters: white ethnicity (OR = 2.561; 95% confidence interval [95%CI]: 1.07 to 6.11); multiparity (OR = 3.50; 95%CI: 1.62 to 7.38), female gender (OR = 4.95; 95%CI: 1.86 to 13.13); and breech presentation (OR = 2.03; 95%CI: 1,01 to 4.11).

Conclusion The prevalence of DDH in the sample was of 5.45% using ultrasound as a diagnostic method. This result is different from that of studies that assessed prevalence exclusively through physical examination (Ortolani maneuver). The main risk factors associated with a higher risk of developing DDH were newborns of the female gender, with breech presentation, firstborns, and of white ethnicity.

Keywords

hip dislocation, congenital - ultrasonography - diagnosis - newborn

Author Contributions

GM: development of the instruments for data collection, data collection, initial analyses, conceptualization and study design, writing of the initial manuscript, and writing and revision of the final manuscript.

AC: review of the literature, and writing and revision of the manuscript.

EC: análysis and preparation of the data for the statistical analysis, and revision of the manuscript.

NV: contribution regarding the sections involving the clinical aspects of pediatric orthopedics and contribuition regarding the sections involving musculoskeletal radiology, and writing and revision of the manuscript.

MLD: writing and revision of the manuscript.

WI: conceptualization and study design, coordination and supervision of the data collection, writing of the initial manuscript, critical revision of the manuscript regarding important intellectual content, and writing and revision of the final manuscript.

^* Work developed at Hospital e Maternidade Escola Dr. Mário de Moraes Altenfelder Silva, São Paulo, São Paulo, Brazil.

Publikationsverlauf

Eingereicht: 30. Oktober 2020

Angenommen: 25. Juni 2021

Artikel online veröffentlicht:
28. Oktober 2021

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