Impact of Traditional Swaddling Practices on the Risk and Early Detection of Developmental Dysplasia of the Hip in Duhok City, Iraq. Prospective Observational Study.

Aim: To identify the frequency of developmental dysplasia of the hip (DDH) in infants subjected to traditional swaddling for awareness purpose and early intervention, in addition to detect the accuracy of clinical and radiological techniques in the diagnosis of cases. Methods: This prospective observational study was conducted by a multidisciplinary team at Azadi Teaching Hospital and Maternity Hospital in Duhok City from October 2022 to October 2024. This study included a total of 110 newborns whose parents continued to practice traditional swaddling despite receiving immediate postnatal warnings against its use. however, newborns who were not exposed to this method of swaddling were excluded. Clinical and radiological assessments were conducted at birth till 6 months of age. Statistical analyses were performed using SPSS version 27 to evaluate the relationship between traditional swaddling and DDH. Results: Among the 110 neonates, 6.4% were diagnosed with DDH by the age of six months. Significant associations were found with female sex, breech presentation, first-born status, and a positive family history. Left-sided hip involvement was predominant. Early ultrasound by about 8 weeks detected dysplasia in 10% of patients, with 54% progressing to DDH. By six months, X-rays imaging confirmed a 6.4% prevalence of DDH. Conclusion: Traditional swaddling practices were linked with an increased risk of DDH, particularly in infants with other risk factors. Ultrasound within the first 3 months and follow-up X-ray at 6 months are reliable diagnostic tools for identifying DDH. Early screening and safe swaddling education are critical for DDH prevention.