Predicting developmental dysplasia of the hip in at-risk newborns.
BMC Musculoskelet Disord
; 21(1): 442, 2020 Jul 07.
Article
en En
| MEDLINE
| ID: mdl-32635922
ABSTRACT
BACKGROUND:
The development of developmental dysplasia of the hip can be attributed to several risk factors and often in combination with each other. When predicting the likelihood of developing this condition, clinicians tend to over and underestimate its likelihood of occurring. Therefore, the study aim is to determine among at-risk newborns how to best predict developmental dysplasia of the hip (DDH) within 8 weeks post-partum.METHODS:
Prospective cohort study in secondary care. Patient population included newborns at-risk for DDH - we assessed 13,276 consecutive newborns for the presence of DDH risk factors. Only newborns with at least one of the predefined risk factors and those showing an abnormal examination of the hip were enrolled (n = 2191). For the development of a risk prediction model we considered 9 candidate predictors and other variables readily available at childbirth. The main outcome measure was ultrasonography at a median age of 8 weeks using consensus diagnostic criteria; outcome assessors were blinded.RESULTS:
The risk model includes four predictors female sex (OR = 5.6; 95% CI 2.9-10.9; P < 0.001); first degree family history of DDH (OR = 4.5; 95% CI 2.3-9.0; P < 0.001), birthweight > 4000 g (OR = 1.6; 95% CI 0.6-4.2; P = 0.34), and abnormal examination of hip (OR = 58.8; 95% CI 31.9, 108.5; P < 0.001). This model demonstrated excellent discrimination (C statistic = 0.9) and calibration of observed and predicted risk (P = 0.35). A model without the variable 'hip examination' demonstrated similar performance.CONCLUSION:
The risk model quantifies absolute risk of DDH within 8 weeks postpartum in at-risk newborns. Based on clinical variables readily available at the point of childbirth, the model will enhance parental counselling and could serve as the basis for real time decisions prior to discharge from maternity wards.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Displasia del Desarrollo de la Cadera
/
Luxación Congénita de la Cadera
Tipo de estudio:
Diagnostic_studies
/
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Female
/
Humans
/
Infant
/
Newborn
/
Pregnancy
Idioma:
En
Revista:
BMC Musculoskelet Disord
Asunto de la revista:
FISIOLOGIA
/
ORTOPEDIA
Año:
2020
Tipo del documento:
Article
País de afiliación:
Reino Unido