Perinatal risk factors for developmental dysplasia of the hip
Perinatal risk factors for developmental dysplasia of the hip
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DOI：
10.1136/fn.76.2.f94
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发表时间：
1997-03-01
影响因子：
4.4
通讯作者：
ByronScott, R
中科院分区：
文献类型：
--
作者：
Chan, A;McCaul, KA;ByronScott, R
目的-为了确定围产期危险因素的发育性髋关节发育不良（DDH），并确定每个因素的风险。方法-在此病例对照研究中，使用逻辑回归分析，所有1127例孤立DDH活出生在南澳在1986年至1993年，并通知南澳大利亚州出生缺陷登记处。对照组包括150 130例活产在南澳在同一时期没有任何通知的先天性abnormals.Results-Breech介绍，羊水过少，女性性别和产次被证实为DDH的危险因素。重要的发现是阴道分娩的风险高于臀位剖腹产（以及急诊分娩的风险高于择期分娩），高出生体重（大于或等于4000 g），过熟和高龄产妇;多胎和早产的风险降低。在无臀位的情况下，剖腹产的风险没有增加。对于臀位介绍，DDH的风险估计至少为2.7%的女孩和0.8%的男孩;一个因素的组合增加了risk. Conclusions，建议确定的风险因素被用作在6周龄时重复筛查的指征，并尽可能在婴儿期。其他适应症是家族史和相关异常。
Aims-To identify perinatal risk factors for developmental dysplasia of the hip (DDH) and define the risk for each factor.Methods-In this case control study, using logistic regression analysis, all 1127 cases of isolated DDH Live born in South Australia in 1986-93 and notified to the South Australian Birth Defects Register were included; controls comprised 150 130 live births in South Australia during the same period without any notified congenital abnormalities.Results-Breech presentation, oligohydramnios, female sex and primiparity were confirmed as risk factors for DDH. Significant findings were an increased risk for vaginal delivery over caesarean section for breech presentation (as well as an increased risk for emergency section over elective section), high birthweight (greater than or equal to 4000 g), postmaturity and older maternal age; multiple births and preterm births had a reduced risk. There was no increased risk for caesarean section in the absence of breech presentation. For breech presentation, the risk of DDH was estimated to be at least 2.7% for girls and 0.8% for boys; a combination of factors increased the risk.Conclusions-It is suggested that the risk factors identified be used as indications for repeat screening at 6 weeks of age and whenever possible in infancy. Other indications are family history and associated abnormalities.