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Risk factors and screening timing for developmental dysplasia of the hip in preterm infants. Background: The delayed diagnosis of developmental dysplasia of the hip (DDH) requires complex treatment and sometimes progresses to hip osteoarthritis regardless. Purpose: This study aimed to evaluate the risk factors and screening time for DDH in preterm infants. Methods: A total of 155 preterm infants with a gestational age < 32 weeks screened for DDH with ultrasonography were enrolled in this retrospective chart review. Results: The incidence of DDH was 6.45% (10/155). Gestational age, birth weight, sex ratio, and breech presentation did not differ significantly between infants treated for DDH (n = 10) and non-treated infants (n = 145) (gestational age, 29.2 ± 1.4 weeks vs. 29.6 ± 2.0 weeks, p = 0.583; birth weight, 1240 ± 237 g vs. 1295 ± 335 g, p = 0.607; female sex, 7/10 (70.0%) vs. 77/145 (53.1%), p = 0.346; and breech presentation, 5/10 (50.0%) vs. 43/145 (29.7%), p = 0.286, respectively). Performing the first ultrasonography earlier than 38 weeks of postmenstrual age (PMA) increased the risk of an abnormal finding by 3.76 times compared to performing it at ≥ 38 weeks of PMA. These abnormal findings on ultrasonography resolved spontaneously. Breech presentation increased the risk of minor abnormal findings on the first ultrasonography by 3.11 times versus non-breech presentation and resolved spontaneously. DDH in preterm infants did not occur predominantly on the left side or in infants born with breech presentation. Conclusion: Performing ultrasonography screening earlier than 38 weeks of PMA caused unnecessary subsequent ultrasonography and overtreatment. Breech presentation was not a risk factor for DDH in preterm infants. However, breech presentation could increase the risk of minor abnormal findings at the 1st ultrasonography compared to non-breech presentation, which resolved spontaneously. The etiology and risk factors for DDH in preterm infants are somewhat different from those for DDH in term infants.