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Title of Paper: Health of children adopted from China

Type of Paper: Original Article; Medical Evaluations and Chart Review

Purpose: To describe the health and development of children adopted from China at the time of arrival.

Nutrition-Related Measures:

Participants: 452 children (443 girls) adopted from China between the ages of 2 months and 12 years at arrival into the U. S.

Methods: Data was collected from two groups of children. Medical and development examinations were completed in an international adoption clinic soon after arrival into the U. S. for 192 children (average age: 14. 2 months). The majority (88%) were seen within 2 months of arrival. The health of 260 children (average age: 6. 5 months) was reported via questionnaires completed by the family physicians.

Developmental testing was done for all of the 192 children who were seen in the international adoption clinic (Peabody Developmental Motor Scales, University of Michigan Early Intervention, Development Profile, and clinical assessment).

Nutrition Results:

Conclusions & Clinical Implications: Children adopted from China show similar growth suppression to children adopted from other regions. Height, weight, and OFC delays were associated with developmental delays. Anemia and lead poisoning were common. Although, not analyzed statistically or discussed in the study, the rate of anemia in children with elevated lead levels was high, perhaps due to the potential interference of lead on iron metabolism. Infection with intestinal parasites was found in 9% of the children, and although not discussed in this paper, intestinal parasites could interfere with proper nutrient absorption and may increase the risk for both macronutrient (e. g. , physical growth) and micronutrient (vitamins and minerals) malnutrition. Abnormal thyroid functioning was reported in 10% of the adoptees, and rickets and cleft palate were reported in 1 and 2 children respectively.

Limitations of the Nutritional Results: The birthdates of children adopted from China are often uncertain and assigned by orphanage staff. Uncertain ages may affect the physical and developmental evaluations after adoption as interpretation of these evaluations are age-dependent. However, ages were not reassigned based on the post-adoption evaluations (except for 2 children). Also, 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 LC, Hendrie NW. Health of children adopted from China. Pediatrics. 2000; 105 (6): e76. http://www.ncbi.nlm.nih.gov/pubmed/10835089

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