The epidemiology of hip dysplasia in the nationwide Norwegian Mother, Father, and Child Cohort Study.

Abstract

Developmental dysplasia of the hip (DDH) is a congenital disorder with several assumed risk factors, including breech presentation, female sex, and familial predisposition. Although several of these risk factors are included in national screening programmes, delayed diagnoses of DDH still occur. The aim of this study was to examine the prevalence of these and other risk factors in order to improve the current screening programmes. This study used data from the Norwegian Mother, Father, and Child Cohort Study (MoBa) and the Medical Birth Registry of Norway (MBRN). We used descriptive statistics and logistic regression analyses. Children with cerebral palsy, syndromic disorders, or developmental delay were excluded from the study. A total of 107,194 children were included, with parents reporting using questionnaires if their child had a diagnosis of, or treatment for, DDH. A total of 3,460 children (3.2%) in MoBa had a diagnosis of DDH, with 1,453 (1.4%) being treated for DDH. Statistically significant risk factors included female sex, breech presentation, and pes equinovarus, whereas plural births and maternal diabetes were protective factors for DDH. Having a Caesarean section did not increase the prevalence of DDH. We were able to confirm previously proposed risk factors such as breech presentation and female sex, whereas other variables such as plural births and Caesarean section were not found to be risk factors. However, regression analysis suggested that there are additional factors which affect the prevalence of DDH. These could be both environmental and genetic factors, highlighting the need for further research on DDH to improve the current screening programmes.