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Comparative Study
. 2017 Mar 16;17(1):78.
doi: 10.1186/s12887-017-0829-5.

Population-based study of the incidence of congenital hip dysplasia in preterm infants from the Survey of Neonates in Pomerania (SNiP)

A E Lange  1   2 , J Lange  3 , Till Ittermann  4 , M Napp  3 , Paul-Christian Krueger  5 , H Bahlmann  6 , R Kasch  7 , M Heckmann  6
Affiliations
Comparative Study

Population-based study of the incidence of congenital hip dysplasia in preterm infants from the Survey of Neonates in Pomerania (SNiP)

A E Lange et al. BMC Pediatr. .

Abstract

Background: Some etiological factors involved in developmental dysplasia of the hip (DDH) occur in the last trimester of pregnancy, which could result in a decreased incidence of DDH in preterm infants. The aim of this study was to compare the incidence of DDH between preterm and term infants.

Methods: Ultrasound of the hip joint was performed in 2,534 term infants and 376 preterm infants within the population-based Survey of Neonates in Pomerania (SNiP) study.

Results: A total of 42 (1.66%) term infants had DDH (Graf type II c, 0.8%; type D, 0.3% left and 0.4% right; type III a, 0.2% left). Eighteen infants had bilateral findings. Hip dysplasia occurred more frequently in female neonates (32/1,182 vs. 10/1,302, p < 0.023; 95% CI 0.012-0.022, χ 2 test). A familial disposition for DDH was found in 169 (6.7%) term infants and 181 (7.1%) infants in the overall population. In preterm infants, dysplasia of the hip was found in only three late preterm infants with gestational age between 36 and 37 weeks (n = 97) and not in preterm infants <36 weeks gestational age (n = 279). Regression analysis revealed a narrowly significant association between gestational week of birth and DDH (relative risk = 1.17; 95% confidence interval 0.99-1.37; p = 0.065).

Conclusion: Our study suggests that preterm infants <36 weeks gestational age have a decreased risk of DDH.

Keywords: Hip dysplasia; Preterm neonate; Screening of neonates; Ultrasound of the hip.

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Figures

Fig. 1
Fig. 1
Effect of gestational age and birth weight on Graf classification in preterm infants of the SNiP cohort. For the left (p < 0.001) and right hip (p < 0.001), extremely preterm and very preterm neonates had a significantly higher incidence of mature hips than late preterm babies. χ 2 95% confidence interval 0.99–1.37
Fig. 2
Fig. 2
Characteristics of the SNiP population. Ultrasound examination of the hip was established in January 2004 and was available in 2,910 infants born between then and November 2008. This subpopulation represented 80% of all preterm infants and 70% of all term infants included in SNiP during the time period. The study region of the Survey of Neonates in Pomerania (SNiP) was ‘Ostvorpommern’ (a, dark grey). SNiP was carried out in three hospitals located in the Hansestadt Greifswald (HGW), Wolgast (WLG) and Anklam (ANK) (b)
Fig. 3
Fig. 3
Gestational age and risk of developmental dysplasia of the hip (DDH). Regression analysis of the association between gestational week of birth and risk of DDH (relative risk = 1.17, 95% confidence interval 0.99–1.37, p = 0.065). One week of gestation was associated with a 16% increased risk of hip dysplasia. Dotted line: 95% confidence interval 1.08–1.63
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