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Diagnosing developmental dysplasia of the hip using the Graf ultrasound method: risk and protective factor analysis in 11,820 universally screened newborns


Schams, Mohammad; Labruyère, Rob; Zuse, Anne; Walensi, Mikolaj (2017). Diagnosing developmental dysplasia of the hip using the Graf ultrasound method: risk and protective factor analysis in 11,820 universally screened newborns. European Journal of Pediatrics, 176(9):1193-1200.

Abstract

The essential role of ultrasound examinations in diagnosis and treatment of developmental dysplasia of the hip (DDH) is widely accepted while the weighting and correlation of protective factors and perinatal risk for DDH still give rise to debate. Our aim was to investigate the impact of single and twofold combined risk and protective factors on the newborns' hip maturity, assessed with the Graf ultrasound method. Therefore, data sets of 11,820 universally screened newborns were analyzed. Univariate and logistic regression analyses were performed to correlate risk and protective factors with mature or immature but appropriate for age and pathologic hip types. Thereby, female gender (OR 4.07 (95% CI 3.01–5.51), p < 0.001), breech presentation (4.98 (3.71–6.71), p < 0.001), and positive family anamnesis (5.05 (3.49–7.31), p < 0.001) as well as the combination of female gender with high birth weight (3.51 (2.45–5.03), p < 0.001) could be identified as independent predictive risk factors. Only low birth weight (0.27 (0.11–0.66), p = 0.004) could be identified as a single protective factor, while no combination of protective factors was significant.
Conclusion: The significance and the informative value of risk and protective factor combinations, e.g., for selective ultrasound surveys, are limited. Early universal ultrasound screening using the Graf method is advised to timely detect hip immaturity and pathologies and to provide the optimal approach for mature or immature but appropriate for age and pathologic hips.

Abstract

The essential role of ultrasound examinations in diagnosis and treatment of developmental dysplasia of the hip (DDH) is widely accepted while the weighting and correlation of protective factors and perinatal risk for DDH still give rise to debate. Our aim was to investigate the impact of single and twofold combined risk and protective factors on the newborns' hip maturity, assessed with the Graf ultrasound method. Therefore, data sets of 11,820 universally screened newborns were analyzed. Univariate and logistic regression analyses were performed to correlate risk and protective factors with mature or immature but appropriate for age and pathologic hip types. Thereby, female gender (OR 4.07 (95% CI 3.01–5.51), p < 0.001), breech presentation (4.98 (3.71–6.71), p < 0.001), and positive family anamnesis (5.05 (3.49–7.31), p < 0.001) as well as the combination of female gender with high birth weight (3.51 (2.45–5.03), p < 0.001) could be identified as independent predictive risk factors. Only low birth weight (0.27 (0.11–0.66), p = 0.004) could be identified as a single protective factor, while no combination of protective factors was significant.
Conclusion: The significance and the informative value of risk and protective factor combinations, e.g., for selective ultrasound surveys, are limited. Early universal ultrasound screening using the Graf method is advised to timely detect hip immaturity and pathologies and to provide the optimal approach for mature or immature but appropriate for age and pathologic hips.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Children's Hospital Zurich > Medical Clinic
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:2017
Deposited On:06 Mar 2018 13:50
Last Modified:14 Mar 2018 18:06
Publisher:Springer
ISSN:0340-6199
OA Status:Closed
Publisher DOI:https://doi.org/10.1007/s00431-017-2959-z
PubMed ID:28717864

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