Orthopedic Morbidities in Neonates: Correlation with Delivery and Maternal Risk Factors

Abstract

Background: Neonatal orthopedic morbidities, such as developmental dysplasia of the hip (DDH), clubfoot, fractures, torticollis, and metatarsus adductus, can significantly impact a child’s development and quality of life.

Objective: The objective of this study is to investigate the relationship between maternal health conditions, including gestational diabetes, hypertension, and smoking, as well as delivery methods, and the prevalence of orthopedic conditions in neonates.

Methods: A cross-sectional observational study was conducted at MTI Lady Reading Hospital Peshawar from June 2023 to June 2024, enrolling 135 neonates. Data were collected on maternal health, delivery method, and neonatal orthopedic conditions. Neonates were examined for conditions such as DDH, clubfoot, fractures, torticollis, and metatarsus adductus.

Results: Of the 135 neonates, 14 (10.4%) were diagnosed with DDH, 9 (6.7%) with clubfoot, 6 (4.4%) with clavicular fractures, 7 (5.2%) with torticollis, and 8 (5.9%) with metatarsus adductus. Cesarean section deliveries were associated with a higher incidence of DDH, with 11.7% of cesarean-delivered neonates diagnosed, compared to 9.3% in vaginal deliveries. Similarly, clubfoot was more prevalent in neonates born by cesarean section (8.3%) compared to those born vaginally (5.3%). Maternal risk factors showed significant associations with neonatal orthopedic conditions. Gestational diabetes, present in 24 mothers (17.8%), was associated with 25% of DDH cases. Multivariate logistic regression revealed that neonates born to mothers with gestational diabetes had an odds ratio of 3.45 (95% CI: 1.12–10.68, p = 0.020) for developing DDH. Hypertension in mothers (11.1%) was associated with 20% of DDH cases, while maternal smoking (6.7%) contributed to 22.2% of DDH cases. Conclusion: The findings of this study suggest that maternal risk factors, particularly gestational diabetes, and delivery methods, especially cesarean section and breech presentations, significantly contribute to neonatal orthopedic morbidities.