Auxological Evaluation and Determinants of Growth Failure at the Time of Adoption in Eastern European Adoptees

Miller, Bradley S.; Kroupina, Maria; Iverson, Sandra; Mason, P.; Narad, Christine; Himes, John H.; Johnson, Dana E.; Petryk, Anna

doi:10.1515/jpem.2009.22.1.31

Cited by 18 publications

(42 citation statements)

References 18 publications

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“…By adoptive parents’ report, all the institutions where the children were adopted were reported to have a poor adult-to-child ratio. The IA group had impairment of height and head size similar to that seen in previous studies (13, 14). Interestingly, we found that USN children did not demonstrate impairment of height or HC.…”

Section: Discussionsupporting

confidence: 86%

Growth failure associated with early neglect: pilot comparison of neglected US children and international adoptees

Miller

Spratt

Himes

et al. 2015

Journal of Pediatric Endocrinology and Metabolism

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The long-lasting impact of different neglectful environments on growth in children is not well studied. Three groups of children, 3–10 years old, were recruited (n = 60): previously institutionalized international adoptees living in stable home environments for at least 2 years (IA; n = 15), children with a history of neglect born in the USA (USN; n = 17), and controls (n = 28). Children underwent physical examination, anthropometry, and collection of serum for growth parameters. Mean height standard deviation scores (SDS) were different (p < 0.05). Age-adjusted head circumference (HC) was significantly smaller (p < 0.05) in IAs. Insulin growth factor (IGF-1), a marker of growth hormone action, was higher in US neglected children. IGF-1 adjusted for age and weight SDS were different (p < 0.05) between control and US neglect groups. The degree of growth failure in height and HC in IAs was more severe than neglected US children. These findings may reflect differences between the impact of chronic and intermittent deprivation on the growth hormone system.

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Section: Discussionsupporting

confidence: 86%

Growth failure associated with early neglect: pilot comparison of neglected US children and international adoptees

Miller

Spratt

Himes

et al. 2015

Journal of Pediatric Endocrinology and Metabolism

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“…Thirty-four articles (representing 33 studies) contained relevant data and were selected for data extraction. A schematic diagram of the search strategy is depicted in Fig 1. Data on the prevalence of FAS and/or FASD in child-care systems were available from only 8 countries, as follows: Brazil (1 study 40 ), Chile (2 studies 41,42 ) Canada (3 studies 4,43,44 ), Israel (1 study 45 ), Russia (10 studies 11,46-55 ), Spain (1 study 56 ), Sweden (3 studies [57][58][59] ), and the United States (USA; 11 studies [60][61][62][63][64][65][66][67][68][69][70] ). One study reported on the prevalence of FAS among preadoption children from Eastern Europe (Romania, Ukraine, Moldova).…”

Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

“…Of the studies that used an ACA approach (ie, those studies that used ACA solely, as well as those that used a mixed-methods approach), 10 studies [40][41][42][49][50][51]62,64,[69][70][71] did not report the system used for diagnosing FAS and/or FASD. Of those studies that did report the diagnostic system used, 7 studies 44,54-56,59,60,66 used the 4-Digit Diagnostic Code, 24 2 studies 48,58 used the IOM diagnostic criteria, 23 2 studies 47,68 used the CDC FAS Guidelines, 15 1 study 46 used the FASD Study Group criteria, 17 and 1 study 63 used the Smith' s Recognizable Patterns of Human Malformations.…”

Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

Prevalence of Fetal Alcohol Spectrum Disorders in Child Care Settings: A Meta-analysis

et al. 2013

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BACKGROUND: Children often enter a child-care system (eg, orphanage, foster care, child welfare system) because of unfavorable circumstances (eg, maternal alcohol and/or drug problems, child abuse/neglect). Such circumstances increase the odds of prenatal alcohol exposure, and thus this population can be regarded as high risk for fetal alcohol spectrum disorders (FASD). The primary objective was to estimate a pooled prevalence for fetal alcohol syndrome (FAS) and FASD in various child-care systems based on data from existing studies that used an active case ascertainment method. METHODS:A systematic literature review, using multiple electronic bibliographic databases, and meta-analysis of internationally published and unpublished studies that reported the prevalence of FAS and/or FASD in all types of child-care systems were conducted. The pooled prevalence estimates and 95% confidence intervals (CIs) were calculated by using the Mantel-Haenszel method, assuming a random effects model. Sensitivity analyses were performed for studies that used either passive surveillance or mixed methods. RESULTS:On the basis of studies that used active case ascertainment, the overall pooled prevalence of FAS and FASD among children and youth in the care of a child-care system was calculated to be 6.0% (60 per 1000; 95% CI: 38 to 85 per 1000) and 16.9% (169 per 1000; 95% CI: 109 to 238 per 1000), respectively. CONCLUSIONS:The results confirm that children and youth housed in or under the guardianship of the wide range of child-care systems constitute a population that is high-risk for FASD. It is imperative that screening be implemented in these at-risk populations.

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“…We and others have previously documented significant physical growth delays in up to 34% of international adoptees from Eastern Europe, South America, and Asia [3–5]. Of the many hereditary, environmental, and hormonal factors that may contribute, we have previously shown that age, prenatal factors (birth weight and risk of fetal alcohol syndrome), and growth factors (Insulin-like Growth Factor Binding Protein-3, IGFBP-3) are independently associated with the degree of growth delay in adoptees upon arrival into the US [4]. …”

Section: Introductionmentioning

confidence: 99%

Determinants of Catch-Up Growth in International Adoptees from Eastern Europe

Miller

Kroupina

Mason

et al. 2010

International Journal of Pediatric Endocrinology

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Children raised in orphanages frequently experience growth suppression due to multiple risk factors. Placing such children in more nurturing environments through adoption leads to significant catch-up growth (CUG), the determinants of which are not entirely understood. The goal of this study was to perform an auxological evaluation and examine the degree and correlates of CUG in international adoptees. Children adopted from Eastern Europe, (n = 148, 71 males), 7 to 59 months of age, were recruited within 3 weeks of their arrival to the US. At baseline, mean height SDS was −1.2 ± 1.1 and 22% were <−2 SDS for height. IGF-1 and/or IGFBP-3 levels <−2 SDS were present in 32%. CUG, defined as a gain of >+0.5 in height SDS, was seen in 62% of adoptees at 6 months after adoption; 7% of children remained <−2 SDS for height (two had growth hormone deficiency). Growth factors improved in the majority of children. Younger age, greater degree of initial growth failure, and higher caloric intake were significantly associated with improved linear growth in multiple regression models. In summary, most adoptees demonstrate excellent CUG within six months after adoption. If growth failure persists after 6 months of appropriate caloric intake, nutrition-independent causes should be considered.

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Auxological Evaluation and Determinants of Growth Failure at the Time of Adoption in Eastern European Adoptees

Abstract: We recommend that IAs undergo screening upon US arrival to identify risk factors for poor growth, particularly evidence of LBW and fetal alcohol exposure. Catch-up growth should be monitored in all children following adoption.

Cited by 18 publications

References 18 publications

Growth failure associated with early neglect: pilot comparison of neglected US children and international adoptees

Growth failure associated with early neglect: pilot comparison of neglected US children and international adoptees

Prevalence of Fetal Alcohol Spectrum Disorders in Child Care Settings: A Meta-analysis

Determinants of Catch-Up Growth in International Adoptees from Eastern Europe

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