Title of Paper: Health of children adopted from Ethiopia
Type of Paper: Original Article; Medical Chart Review
Purpose: To describe the health & development of children adopted from Ethiopia or Eritrea at the time of arrival.
- Physical growth: standard anthropometry [height, weight, head circumference (OFC)]. Z scores were calculated using CDC 2000 as a reference.
- Anemia: complete blood cell count
- Thyroid function: thyroid stimulating hormone and thyroxine
Participants: 50 children adopted from Ethiopia or Eritrea between the ages of 3 months and 15 years (62% were younger than 4 years old) who were seen at one international adoption clinic.
Methods: Chart review of medical evaluations that had been completed soon after arrival.
- Physical growth:
- Average z scores were below the mean (i.e., z score of 0). Average z scores were:
- Height for age (HAZ): -0. 64 (range: -3. 17 to 2. 31)
- Weight for age (WAZ): -0. 59 (range: -3. 54 to 2. 23)
- Head circumference for age (OFCZ): -0. 09 (range: -2. 63 to 1. 99)
- The following number of children were below -2 z scores for growth (-2 z scores is equivalent to approximately the 5th percentile):
- HAZ: 12%
- WAZ: 8%
- OFCZ: 6%
- Weight for height (WHZ) tended to increase with age at adoption, but other growth measures did not correlate with age at arrival.
- Anemia: 1 child had anemia (hematocrit <30%).
- Thyroid Function: 10% had minor, temporary thyroid abnormalities.
Conclusions & Clinical Implications: Children adopted from Ethiopia had better growth compared to children adopted from China, Guatemala, or Russia who were seen in the same clinic. The authors speculate that one reason for this difference is that many of the children from Ethiopia spend less time in institutional care and more time with families (and often are breast-fed) compared to children adopted from other countries. There may also be differences in institutional quality or ethnic growth differences. There was very little anemia or thyroid function abnormalities in children adopted from Ethiopia.
Limitations of the Nutritional Results: Physical growth suppression may have been underestimated in this study due to uncertain ages of many of the children. Ages were often assigned based on the child’s growth and development. If children have either growth or developmental delays, a younger age may be assigned than their actual age leading to an underestimation of growth suppression. Screening for anemia and iron deficiency was limited. The only marker used to identify anemia was hematocrit, and it was not reported whether the anemia was due to iron deficiency or another etiology.
Reference: Miller L, Tseng B, Tirella L, Chan W, Feig E. Health of children adopted from Ethiopia. Maternal & Child Health Journal. 2008; 12: 599-605. http://www.ncbi.nlm.nih.gov/pubmed/17712613