Perinatal risks and prevention of hip disorders in premature babies

Abstract

The relevance of the study is due to the low level of start-up health in premature children and the high risk of its loss at an extreme degree of immaturity in the long-term simulation of intrauterine development conditions, which requires the development of complex technologies for early prediction and prevention of musculoskeletal deformations.
Purpose. To determine perinatal risk factors and frequency of hip joint formation disorders taking into account gestational and postconceptual age of premature children in combination with evaluation of osteogenesis markers for prediction and early prevention of bone system pathology.
Materials and methods. A comprehensive examination of 120 premature and 20 dead children was carried out with analysis of perinatal factors, data of ultrasonic examination of hip joints and assessment of bone metabolism.
Results. Mothers who gave birth prematurely with dysplastic hip joints were significantly more likely to have gestosis (p=0.013), chronic fetoplacental insufficiency (p=0.004), colpitis (p=0.004). In ultrasonic evaluation, the most common (84.6%) bilateral hip dysplasia was recorded in 36 weeks of postconceptual age. Centric tables of the distribution a and β of the angle of hip joints in premature joints have been developed. Lower levels of osteocalcin (29.75 (17.96; 35.55) ng/ml, p<0.05) was observed in children with dysplastic hip joints. A method of medical prevention of hip dysplasia in premature patients has been developed, which included a comprehensive assessment of clinical-laboratory and instrumental data in combination with the use of positional stacking in the provision of medical care.
Conclusions. Perinatal risk factors of hip joint formation disorders in premature patients were gestosis, chronic fetoplacental insufficiency, colpitis in their mothers, gender in the female sex. Immature hip joints have been detected in 63.8% of premature children with the prevalence of unilateral localization on the right. The most informative period for ultrasonic assessment of hip joint condition in premature patients is postconceptual age corresponding to 36 gestation weeks, or gestational age 35 weeks. Premature children with impaired hip joint formation have lower osteocalcin level while maintaining physiological strong direct correlation between calcium metabolism indices. In order to prevent the formation of bone deformities, an effective method of medical prevention of hip dysplasia in premature children has been developed and introduced into practical work.
The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of an participating institution. The informed consent of the patient was obtained for conducting the studies.No conflict of interest was declared by the authors.