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Title of Paper: Iron deficiency in international adoptees from Eastern Europe

Type of Paper: Original Article, Prospective Study

Purpose: To assess iron deficiency in children adopted from Eastern Europe.

Nutrition-Related Measures:

Participants: 37 children adopted from Eastern Europe who were under the age of 24 months at arrival. Age range at first assessment (soon after arrival) was 9 to 23 months (average age was 15. 7 months).

Methods: Physical growth, iron deficiency, and dietary intake were collected at baseline (within one month of arrival) and six months later.

Nutrition Results:

Conclusions & Clinical Implications: Children adopted from Eastern Europe experience growth delays at arrival followed by post-adoption catch-up growth in height, weight, weight for height, and head circumference. Iron deficiency was common at arrival and did not improve significantly during the first six months post-adoption, despite the improvements in the nutritional and social environments. Some children even developed iron deficiency after arrival. Iron deficiency was more common in children with the intestinal parasite Giardia, which may interfere with iron absorption. Post-adoption catch-up growth also increased the risk for iron deficiency. This study emphasizes that the post-adoption catch-up growth increases the demands for iron and increases the risk for iron deficiency, even though the children on average were consuming the recommended intake of iron. Furthermore, this study found that adoptees are at risk for iron deficiency without anemia, and general pediatric practice has been to only screen for anemia. Under this practice, children with iron deficiency who do not have anemia will go undiagnosed.

Limitations of the Nutritional Results: This is the first study to investigate iron deficiency (not just anemia) in international adoptees, and it included only a small group. Investigation of iron deficiency, especially in children from other birth countries, is needed to determine the risk for international adoptees and children living in institutions.

Reference: Fuglestad AJ, Lehmann A, E. , Kroupina M, G. , et al. Iron deficiency in international adoptees from Eastern Europe. The Journal of Pediatrics. 2008; 153: 272-277. http://www.ncbi.nlm.nih.gov/pubmed/18534235

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