Incidence trends and perinatal risk factors of developmental dysplasia of the hip: a nationwide population-based study from South Korea

Abstract

Background and purpose - South Korea has implemented the National Health Screening Program for Infants and Children (NHSPIC), which includes clinical hip screening with selective hip ultrasonography beginning at 4 months of age. We aimed to investigate the trends in developmental dysplasia of the hip (DDH), associated risk factors, and growth and motor developmental outcomes up to preschool age. Methods - We included a retrospective, population based birth cohort of children born between 2008 and 2015. Patients diagnosed with DDH were stratified by age at detection (early diagnosed [<1 year] vs late diagnosed [>= 1 year]) and treatment modalities (major surgery, minor surgery, or nonoperative). Growth and motor developmental outcomes were assessed using NHSPIC data collected up to 6 years of age. Results - Among 2,518,805 children, 4,854 (0.19%) were diagnosed with DDH. The incidence of DDH increased from 1.29 to 2.37 per 1,000 individuals, with the incidence of early diagnosed DDH increased from 0.70 to 1.94 per 1,000. However, the rate of surgical treatment remained unchanged (0.19-0.28 per 1,000). Children who underwent surgical treatment for DDH had a significantly higher incidences of short stature, and delayed gross motor development. Conclusion - After the introduction of the NHSPIC hip screening program, incidences of overall and early diagnosed DDH increased, whereas the surgical treatment rate showed no significant change. Surgical treatment for DDH was significantly associated with both short stature and delayed gross motor development.