Ultrasound Screening And Risk Factor Study Of Infants With DDH In Central Inner Mongolia

Objective:Regional screening was carried out for infants aged 0-6 months by ultrasound technology.Data were collected and analyzed statistically to investigate the condition of developmental dysplasia of the hip(DDH)in the central region of Inner Mongolia(Hohhot city and its surrounding cities).The risk and predisposing factors associated with DDH were analyzed.To study the correlation between maternal childbearing age,gestational age,birth weight and DDH.The importance of ultrasonography in the early diagnosis of DDH is emphasized,which provides valuable reference for the prevention,treatment and publicity of DDH.Methods:Regional ultrasound screening was carried out for infants aged 0-6 months from the Child Health hospitalsin in the central region of Inner Mongolia.And they were divided into DDH group(type II to IV)and normal hip group(type I)according to the ultrasound results,and a face-to-face questionnaire survey was conducted among parents or effective guardians of the examined infants.The data content consists of two parts.The first part is the relevant information of ultrasound examination,including age,gender,profile and DDH classification.The second part is the birth weight,birth mode,fetal position,amniotic fluid volume,maternal age,gestational age,etc.The investigation results were statistically analyzed to evaluate the incidence of DDH,verify the correlation between DDH and risk factors,and explore the relationship between DDH and maternal childbearing age,gestational age and infant birth weight.Results:(1)A total of 27853 infants were examined,and 98 cases were diagnosed with DDH by hip ultrasonography,with a detection rate of 3.5‰.The detection rates of DDH in male and female were 1.86‰and 5.20‰,and the detection rate of female infants was higher than that of male infants,the difference was statistically significant(x~2=22.165,P<0.001).The mean age of mothers in DDH group was higher than that in healthy group,and the difference was statistically significant(t=4.508,P<0.001).The detection rate of breech birth DDH infants was higher than cephalic birth DDH infants,and the difference was statistically significant(x~2=22.956,P<0.001).The detection rate of DDH infants during caesarean section was higher than that during natural delivery,and the difference was statistically significant(x~2=257.57,P<0.001).The detection rate of hypoamniotic fluid volume in DDH group was higher than that of normal or excessive amniotic fluid,and the difference was statistically significant(x~2=1617.86,P<0.001).(2)All the infants were grouped according to0-6 months of age.The detection rate of DDH<1 month old was 0.56%,the age of 1 to 2months was 0.45%,2 to 3 months of age was 0.42%,3 to 4 months of age was 0.31%,4 to 5months of age was 0.20%,and 5 to 6 months of age was 0.16%.The detection rate of DDH in different age groups decreased with age increasing,and the difference was statistically significant(x~2=16.105,P=0.007).(3)According to birth weight,the infants were divided into three groups:low weight(<2500g),normal weight(2500g～4000g)and giant baby(>4000g).The composition ratio of DDH children in different weight groups was compared between groups,and the difference was statistically significant(x~2=12.289,P<0.001).(4)Univariate logistic regression analysis shoued that the sex(OR=2.808,95%CI:1.792-4.400,P<0.001),the fetal position(OR=3.486,95%CI:2.165-5.614,P<0.001),the mode of delivery(OR=13.097,95%CI:8.724-19.662,P<0.001)and amniotic fluid volume(OR=79.586,95%CI:52.470-120.715,P<0.001)were strong risk factors for DDH.Multivariate logistic regression analysis shoued that the sex(OR=2.983,95%CI:1.811-4.914,P<0.001),the fetal position(OR=1.097,95%CI:1.014-1.181,P=0.019),the mode of delivery(OR=7.141,95%CI:4.054-12.576,P<0.001),the amniotic volume(OR=60.513,95%CI:37.223-98.375,P<0.001),the maternal childbearing age(OR=1.094,95%CI:1.031-1.160,P=0.003),the gestational age(OR=1.094,95%CI:1.022-1.169,P=0.011),and birth weight(OR=5.768,95%CI:3.181-10.458,P<0.001)were an associated risk factor for DDH.Conclusion:1.Ultrasonography can accurately assess the infant hip joint at an early stage and is an effective method for the diagnosis of DDH,contributing to earlier treatment and follow-up.2.In this study,the detection rate of DDH was 3.5‰.With the growth and development of infants after birth,the detection rate of DDH gradually decreased.The female,breech births,caesarean section,and low amniotic fluid volume need early ultrasound screening for prompt diagnosis and treatment.3.Through the analysis of maternal childbearing age,preterm birth and infant birth weight,the understanding of DDH related factors was strengthened.This epidemiological information may inform health care planning and screening policies.