Abstract

Objective: Because the greater frequency of developmental dyplasia of the hip (DDH) in the female could have an endrocrine etiology and maternal smoking in pregnancy causes fetal endocrine disequilibrium, we investigated the anatomy of the hip in neonates of smoking (SM) and nonsmoking mothers (NSM). Study design: Clinical – sonographic examination was performed on 2066 hips of 521 male and 512 female neonates. In 48 male and 53 female neonates the mothers smoked during pregnancy. Results : The mean + SD a angle in the male neonates of the NSM was 62.3ο ± 5.1ο and of the SM 62.1ο ±4.9ο (NS). In the female neonates 95 of the NSM and the SM it was 60.7ο ±5.3ο and 61.9ο ±4.8ο, respectively (p=0.02). The difference between the male and the female neonates of the NSM is significant (p<0.000001), but there is no significant difference between the female neonates of the SM and the male neonates. Among the female neonates whose mothers were nonsmokers the number of those with hip Type IIa or worse was significantly greater that among those whose mothers were smokers. The clinical findings were in the same direction as those of the sonographic findings suggesting hip protection by maternal smoking in the female. Conclusions: Maternal smoking during pregnancy reduces the frequency of sonographic and possibly clinically detected DDH in female but not in male neonates. The tobacco – induced hip protection may have an endocrine basis.

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