Incidence and Associated Risk Factors of Neonatal Developmental Dysplasia of the Hip in Saudi Arabia: A Retrospective Cohort Study.

Abstract

Purpose: Developmental dysplasia of the hip (DDH) is a malformation of the hip joint that can lead to subluxation or dislocation. Early diagnosis is crucial for effective non-surgical management. The reported prevalence of DDH varies across studies.

Objective: To determine the cumulative incidence of DDH based on clinical examination and diagnostic ultrasonography and to identify associated risk factors.

Patients and methods: Between January 2020 and June 2023, 279 ultrasound studies were retrieved from the Security Forces Hospital in Makkah, Saudi Arabia. From the patients' files, we identified risk factors for DDH, including prematurity, gender, breech presentation, mode of delivery, and family history using the Chi-square test and odds ratios (OR).

Results: After excluding two cases with chromosomal abnormalities, the final cohort included 277 neonates (60.6% female) and 39.4% males. A positive family history was present in 5%, and 31.5% had a breech presentation. The Ortolani and Barlow tests indicated a DDH incidence of 8.05 per 1000 live births, while selective ultrasound confirmed an incidence of 2.13 per 1000 live births. Prematurity was significantly associated with DDH (P = 0.046), and breech presentation increased the risk approximately fourfold, OR = 3.95, P = 0.016.

Conclusion: DDH incidence in Makkah aligns with global averages. Prematurity significantly increases DDH risk, and breech presentation increases the risk by approximately four times.