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There is No Link Between Birth Weight and Developmental Dysplasia of the Hip

There is No Link Between Birth Weight and Developmental Dysplasia of the Hip
There is No Link Between Birth Weight and Developmental Dysplasia of the Hip

Aims: Developmental Dysplasia of the Hip (DDH) has been linked to high birth weight and packaging disorders, though the evidence is limited. This has implications on screening strategies. The aim of this study was to establish whether birth weight was truly associated with the incidence of DDH.

Patients and Methods: This cohort study analysed the birth weights of all babies born at our institution over a 24 month period, between 01/01/2017 and 01/01/2019. Babies with DDH and those without DDH were compared. Babies were excluded if born before 38 weeks, had incomplete data or were a non-singleton pregnancy. Sub-analysis was performed for DDH severity (dysplastic versus subluxed/dislocated hips), breech presentation, gestational age, gender and ethnicity. Statistical analysis was performed using SPSS.

Results: There were 10,113 babies born at our institution during the selected timeframe, of which 884 were excluded for prematurity, 336 for being non-singleton and 19 for incomplete data. This left 8874 for analysis, of which 95 babies had confirmed DDH. Both the Non-DDH and DDH data sets had normal distribution (Shapiro-Wilkes, p  = 0.308 and 0.629, respectively), with mean birth weights of 3477.7 g with DDH and 3492.8 g without DDH. No difference in birth weight was found (Independent T test, p  = 0.789). Females had a lower birth weight than males (3293.1 g versus 3416.6 g ( p  < 0.001)) yet have a higher incidence of DDH (ratio 6:1 in this dataset). No significant difference was found between birth weights of females with and without DDH ( p  = 0.068), nor between males with and without DDH ( p  = 0.513). There were no significant differences in birth weights even when only displaced hips were analysed ( p  = 0.543), nor according to breech presentation ( p  = 0.8). Longer gestation babies weighed more ( p  < 0.00001), yet showed no increase in DDH incidence ( p  = 0.64).

Conclusion: This study discredits the belief that DDH may be related to higher birth weight, thus casting doubt on the link to DDH being a packaging problem in utero. This, therefore, allows future research to prioritise the investigation of alternative aetiologies.

Birth weight, Developmental Hip Dysplasia, Dislocated, Packaging disorder, Reduced but dislocatable, Reduced but dysplastic
0019-5413
1515-1522
Hanratty, Charlotte
1591f3ae-bfb0-496c-aa02-a4a91184a0df
Thyagarajan, Balamurugan
35ab1c17-1caf-442b-b4cc-c2dfb5b8a7ac
Clarke, Nicholas M.
7f169b2b-e7be-48f4-887a-1f2d3c12dc13
Aarvold, Alexander
11dc317f-47fd-4b2c-b0a6-78688c679b5a
Hanratty, Charlotte
1591f3ae-bfb0-496c-aa02-a4a91184a0df
Thyagarajan, Balamurugan
35ab1c17-1caf-442b-b4cc-c2dfb5b8a7ac
Clarke, Nicholas M.
7f169b2b-e7be-48f4-887a-1f2d3c12dc13
Aarvold, Alexander
11dc317f-47fd-4b2c-b0a6-78688c679b5a

Hanratty, Charlotte, Thyagarajan, Balamurugan, Clarke, Nicholas M. and Aarvold, Alexander (2021) There is No Link Between Birth Weight and Developmental Dysplasia of the Hip. Indian Journal of Orthopaedics, 55 (6), 1515-1522. (doi:10.1007/s43465-021-00465-8).

Record type: Article

Abstract

Aims: Developmental Dysplasia of the Hip (DDH) has been linked to high birth weight and packaging disorders, though the evidence is limited. This has implications on screening strategies. The aim of this study was to establish whether birth weight was truly associated with the incidence of DDH.

Patients and Methods: This cohort study analysed the birth weights of all babies born at our institution over a 24 month period, between 01/01/2017 and 01/01/2019. Babies with DDH and those without DDH were compared. Babies were excluded if born before 38 weeks, had incomplete data or were a non-singleton pregnancy. Sub-analysis was performed for DDH severity (dysplastic versus subluxed/dislocated hips), breech presentation, gestational age, gender and ethnicity. Statistical analysis was performed using SPSS.

Results: There were 10,113 babies born at our institution during the selected timeframe, of which 884 were excluded for prematurity, 336 for being non-singleton and 19 for incomplete data. This left 8874 for analysis, of which 95 babies had confirmed DDH. Both the Non-DDH and DDH data sets had normal distribution (Shapiro-Wilkes, p  = 0.308 and 0.629, respectively), with mean birth weights of 3477.7 g with DDH and 3492.8 g without DDH. No difference in birth weight was found (Independent T test, p  = 0.789). Females had a lower birth weight than males (3293.1 g versus 3416.6 g ( p  < 0.001)) yet have a higher incidence of DDH (ratio 6:1 in this dataset). No significant difference was found between birth weights of females with and without DDH ( p  = 0.068), nor between males with and without DDH ( p  = 0.513). There were no significant differences in birth weights even when only displaced hips were analysed ( p  = 0.543), nor according to breech presentation ( p  = 0.8). Longer gestation babies weighed more ( p  < 0.00001), yet showed no increase in DDH incidence ( p  = 0.64).

Conclusion: This study discredits the belief that DDH may be related to higher birth weight, thus casting doubt on the link to DDH being a packaging problem in utero. This, therefore, allows future research to prioritise the investigation of alternative aetiologies.

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More information

Accepted/In Press date: 20 July 2021
e-pub ahead of print date: 30 August 2021
Additional Information: Publisher Copyright: © 2021, The Author(s).
Keywords: Birth weight, Developmental Hip Dysplasia, Dislocated, Packaging disorder, Reduced but dislocatable, Reduced but dysplastic

Identifiers

Local EPrints ID: 451149
URI: http://eprints.soton.ac.uk/id/eprint/451149
ISSN: 0019-5413
PURE UUID: 4535946a-26b0-4401-bf60-da5a8c551519

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Date deposited: 14 Sep 2021 15:24
Last modified: 16 Mar 2024 13:56

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Contributors

Author: Charlotte Hanratty
Author: Balamurugan Thyagarajan
Author: Nicholas M. Clarke
Author: Alexander Aarvold

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