Result of the Study of Some Influencing Factors of Developmental Dysplasia of the Hip Among Children Under 5 Years Old in Mongolia / Монголын Анагаах Ухаан

ABSTRACT

In recent years, not only in our country also in other foreign countries, there is a tendency that the number of newborn with the developmental dysplasia of the hip (DDH) is going to be increased. For our country, there are few research activities or analyses on negative factors for anomaly, and prevalence of developmental dysplasia of the hip or birth defects of hip. In addition, it considers that birth defect is increasing involved with external environment contamination and other unpleasant factors of population and decision-makers. In conclusion, there is a tendency of increasing DDH cases among the newborns and the above risk factors may affect in certain extent. We need to conduct in-depth study on prevalence and risk factor to DDH in Mongolia and develop further on prevention and management of DDH in newborns. Goal To study some risk factors infl uences to DDH in under 5 years old children and develop further on prevention and management of DDH in newborns. Materials and Methods The sampling size of the research is based on the number of under 5 years old children with DDH diagnose or Q18-79 classifi cation, and the number of under 5 years old children with DDH who are under the control of family physicians in central 6 districts (BZD, BGD, SBD, SKHD, KHUD, and CHD), Ulaanbaatar city. In addition, we have selected total 90 mothers with under 5 years old children who were treated, and served by outpatient visit in district clinics for case group. Occupational physicians diagnosed these children and certifi ed that they have DDH. In addition, we have selected total 90 mothers by 11 with under 5 years old healthy children with it sex and ages above-mentioned using sampling method for control group. The following programs were used to analyze the data The study data was entered by Excel spreadsheets. SPSS 11.4 program was used to analyze the data. Result In our research, and 55 or 61.1% of the children are girls and 35 children or 38.9% are boys. First-born children are 57.8% of case group mothers and 52.2% of control group mothers. In consideration for birth type of babies involved in our research, 22.2% of children with developmental dysplasia of the hip and dislocated hip were born by caesarean section, and in statistic probability, most of them are girls (p=0.08.t=2.8). The relevance of birth type has a direct low (Rxy=0.3) bearing on the fetal lie and the wrong fetal lie is the cause of caesarean section. In case group, average birth weight is 317668.5, the limit of weight is 1400-4600 kg while in control group average birth weight is 327853.2, the limit of weight is 1900-4500 kg (p=0.14). 14.5% of the case group children in our research have hereditary disease, 7.8% of that are from female side and 6.7% (p=0.04) are from male side and for control group children with developmental dysplasia of the hip and dislocated hip, 4.4% of them are from female side disease. In the clarifi cation of previous pregnancy of mother with DDH baby now, it says that 18.9% of total mothers have negative genetic and most of them had had an abortion and natural abortion in repeated amount. The negative genetic of mothers previous pregnancy in case and control group is deferent in its statistical probability (p=0.006). 4.4% of mothers with DDH defect had given a birth before with DDH defects also. Case group children were also clarifi ed if they have other birth defects. In the result of the clarifi cation, there are 6 or 6.7% of case group children with other birth defect and 4 of them have cardiac arrhythmia and cardiac ventricle fi stula, 1 with elbowjoint defect, and 1 with ankle joint and heel, for control group, there are 3 children or 3.3% with birth cardiac defects (OR=2.07;0.5-8.5). 74.4% of control group mothers were kept under the control when they were in their 1-3rd month of pregnancy and 25.6% of them were kept under the control when they were in their 4-6th month of pregnancy (p=0.06). Most of the case group mothers or 65.6% and 48.9% of control group mothers had anaemia. Anaemia is different between the case and control group in statistical probability (p=0.024). 51.1% of case group and 32.2% of control group mothers were suffered communicable disease. Communicable disease is different between the case and control group in statistical probability (OR=2.2 (1.201-4.028), p=0.01). 93.5% of case group and 93.1% of control group mothers had suffered from diseases like infl uenza and influenza. 85.6% of case group, 28.9% of control group mothers were with chronic diseases. Mothers chronic diseases is is different between the case and control group in statistical probability (OR=14.58 (6.93-30.67), p=0.005). Conclusion: 1. For DDH had become such factors as heritage, age of mother, pregnancy surveillance time period, birth weight of the baby, pregnancy complications and ailments, mothers virus infection, anemia, chronic diseases, working conditions, use of medications and preparations that infl uence both singularly or jointly. 2. It is possible to prevent those factors and for doing this, it is in need of providing the women of age of possible pregnancy, nursing mothers, and parents with necessary information by the family and midwife gynecologist doctors.