Perspectives of mothers regarding infant swaddling and hip health in Riyadh, Saudi Arabia: Behavioral trends and associated determinants.

Abstract

Background: Infant swaddling that restricts physiological hip flexion and abduction has been identified as a modifiable postnatal risk factor for developmental dysplasia of the hip (DDH). Despite increasing biomechanical evidence linking improper swaddling techniques to adverse hip development, caregiver-related determinants of hip-safe swaddling practices remain insufficiently characterized in Middle Eastern populations.

Objective: To assess maternal knowledge of DDH and safe swaddling practices and to examine socio-demographic and informational factors associated with knowledge adequacy among mothers residing in Riyadh, Saudi Arabia.

Methods: A cross-sectional web-based survey was conducted among mothers with at least one child aged ≤ 5 years living in Riyadh. Data were collected using a previously validated questionnaire assessing DDH awareness and swaddling practices. Knowledge scores were calculated and categorized using predefined thresholds. Associations between socio-demographic characteristics and knowledge levels were examined using Pearson's Chi-squared test.

Results: Among 436 respondents, the mean DDH knowledge score was 67%, while knowledge of correct swaddling practices averaged 46.9%. Higher maternal educational attainment and receiving infant care information from healthcare professionals were independently associated with adequate DDH knowledge. Early DDH screening before 6 months of age was also independently associated with adequate swaddling-related knowledge. Reliance on informal information sources, including family members and social networks, was more frequently observed among participants with lower knowledge scores.

Conclusion: Maternal awareness of DDH does not consistently translate into knowledge of appropriate hip-safe swaddling techniques. Integration of anticipatory guidance on safe infant positioning into routine pediatric preventive care may represent a modifiable pathway for reducing caregiver-related DDH risk exposures during early infancy.