Descriptive epidemiology of clubfoot in Vietnam: a clinic-based study

Abstract

The prevalence of congenital talipes equinovarus (clubfoot) in Vietnam is estimated to be approximately one in 1000 births. To date, no epidemiological studies have been conducted in this country to assess risk factors associated with this deformity. The purpose of this study was to evaluate specific environmental and socioeconomic factors that may increase the risk of an infant being born with clubfoot. A descriptive clinic-based study was conducted using structured questionnaires given to biological mothers of clinically confirmed clubfoot subjects (n=99) and biological mothers of children between ages 0-18 with no first or second degree family history of clubfoot as controls (n=97). Phenotypic data from clubfoot subjects was also collected. We found that males were twice as likely to have clubfoot and half of clubfoot subjects were affected bilaterally. There was no significant difference in the rate of left versus right clubfoot. Infant and maternal characteristics showing a strong association with clubfoot included breech presentation at birth (p=0.026) and young maternal age (p=0.033). Although there were no strong correlations with any sociodemographic paternal characteristics, a higher percentage of case fathers were younger at the age of conception compared to control fathers. The information from this preliminary study provides a framework for future epidemiologic studies in this population. An understanding of the risk factors associated with clubfoot will play an important role in understanding the pathophysiology of this disabling deformity.