Family history, breech presentation predict developmental dysplasia of hip in early life

A meta-analysis suggests that a family history of developmental dysplasia of the hip (DDH) and breech presentation in pregnancy contribute to a substantial increase in the risk DDH in infants within the 3 months of life.

Researchers searched multiple online databases for studies in which the association of previously proposed risk factors for the risk of sonography-verified DDH was examined. The studies had to be randomized clinical trials and cohort, case-control, and cross-sectional studies that involved infants younger than 3 months with a diagnosis of DDH as detected by hip ultrasonography using the criterion standard Graf method.

The search yielded a total of 5,363 studies, of which 20 met the eligibility criteria and were included in the analysis. These studies involved 64,543 infants.

Pooled data showed that the risk of DDH was positively associated with breech presentation (odds ratio [OR], 4.15, 95 percent confidence interval [CI], 2.62–6.57), family history of DDH (OR, 3.83, 95 percent CI, 2.05–7.15), female sex (OR, 2.50, 95 percent CI, 1.74–3.59), oligohydramnios (OR, 3.76, 95 percent CI, 1.66–8.53), and high birth weight (OR, 2.00, 95 percent CI, 1.60–2.49).

Factors including caesarean delivery, primiparity, multiple births, low birth weight, and prematurity showed no association with DDH risk.

High heterogeneity (I2>70.00 percent) was observed across all factors except high birth weight (I2=0 percent).