Title: Association of maternal age and order of pregnancy with prevalence and severity of clubfoot- A single-center observational study
Authors: Pabitra Kumar Sahoo, Imran Sajad P, Sakti Prasad Das
DOI: https://dx.doi.org/10.18535/jmscr/v11i1.21
Abstract
Background: Congenital talipes Equinovarus (CTEV) is one of the most common congenital anomalies of the lower extremity with an incidence rate of 1-2 per 1000 live births. Diagnosis is mostly by history and clinical evaluation. The Ponseti method of clubfoot management is accepted worldwide as the most ideal treatment for CTEV. Findings regarding maternal age and parity of the mother have been inconsistent and relate differing associations with idiopathic CTEV.
Objectives: To evaluate the factors like maternal age and order of pregnancy and their association with the prevalence and severity of CTEV in a geographically defined population
Methods: This was an observational descriptive cross-sectional study done among 173 children with CTEV deformity. The subjects were selected as per inclusion criteria. Data collected were analyzed using SPSS.
Results: The prevalence of CTEV was predominant in male children (67.1%). CTEV child born from mothers in the age group of 18-25 years constitutes 63% of all. The majority of CTEV babies (60%) were born in the first birth order of mother. No association between birth order and the association between isolated/multiple congenital defects with CTEV has been determined in our study setting (p=0.30)
Conclusion: Early maternal age-related to the high prevalence of children born with clubfoot deformity. The severity of clubfoot was assessed with the Pirani score for both feet when compared with the birth order of the child, the results were statistically not significant.
Keywords: Congenital Talipes Equinovarus, Clubfoot, Pirani score, Ponseti method.
References
- Kelsey J. Epidemiology of musculoskeletal disorders. In: Monographs in Epidemiology and Biostatistics. Editor: Kelsey J. New York: Oxford University Press, 1982; pp. 3–47.
- Morrissy R, Weinstein S. Lovell and Winter’s Pediatric Orthopaedics. 5th edn. Philadelphia: Lippincott, Williams and Wilkins, 2001
- Chung C, Nemechek R, Larsen I, Ching G. Genetic and epidemiological studies of clubfoot in Hawaii. Human Heredity 1969; 19:321–342.
- Owen RM, Penny JN, Mayo A, Morcuende J, Lavy CBD. A collaborative public health approach to clubfoot intervention in 10 low-income and middle-income countries: 2-year outcomes and lessons learnt. J Pediatr Orthop Part B. 2012 Jul;21(4):361–5.
- Miedzybrodzka Z. 2003. Congenital talipes equinovarus (clubfoot): a disorder of the foot but not the hand. J Anat 202(1):37–42
- Wynne-Davies R. Genetic and environmental factors in the etiology. of talipes equinovarus. ClinOrthop Relat Res. 1972;84:9–13.
- Victoria-Diaz A, Victoria-Diaz J. Pathogenesis of idiopathic clubfoot Clin Orthop Relat Res. 1984;185:14–24.
- Cardy AH, Barker S, Chesney D, et al. 2007. Pedigree analysis and epidemiological features of idiopathic congenital talipes equinovarus in the United Kingdom: a case-control study. BMC Musculoskelet Disord 8:62
- Samantha E. Parker et al. Multistate Study of the Epidemiology of Clubfoot. Birth Defects Research (Part A). 2009; 85:897–904
- Wang, H., Barisic, I., Loane, M., Addor, M. C., Bailey, L. M., Gatt, M.,Garne, E. (2019). Congenital clubfoot in Europe: A population-based study. American Journal of Medical Genetics. Part A, 179(4), 595–601
- Stoll C, Alembick Y, Dott B, Roth MP. Associated anomalies in cases with congenital clubfoot. American Journal of Medical Genetics Part A. 2020 Sep;182(9):2027-36.
- Chen C, Kaushal N etal. Clubfoot Etiology: A Meta-Analysis and Systematic Review of Observational and Randomized Trials. J Pediatr Orthop . 2018; Volume 38, Number 8,
- Liu YB, Zhao L, Ding J, Zhu J, Xie CL, Wu ZK, Yang X, Li H. Association between maternal age at conception and risk of idiopathic clubfoot. Acta Orthop. 2016 Jun;87(3):291-5
- Hollier LM, Leveno KJ, Kelly MA, MCIntire DD, Cunningham FG. Maternal age and malformations in singleton births. Obstet Gynecol. 2000 Nov;96(5 Pt 1):701-6.
- Pavone V, Bianca S, Grosso G, Pavone P, Mistretta A, Longo MR, Marino S, Sessa G. Congenital talipes equinovarus: an epidemiological study in Sicily. Acta Orthop. 2012 Jun;83(3):294-8.