Title of Paper: Medical evaluation of internationally adopted children.
Type of Paper: Original Article; Prospective Medical Evaluations
Purpose: To create standardized recommendations for medical evaluations in internationally adopted children.
Nutritional Component: Nutrition-related measures included:
- Physical growth: standard anthropometry [height, weight, head circumference (OFC)]. Z scores were calculated using the World Health Organization standards.
- Anemia: complete blood cell count
- Intestinal Parasites: stool examination for ova and parasites
Participants: 293 internationally adopted children. The mean age was 13 months (the range was 1 month to 14 years). Children were adopted from the following regions: 41% from Korea, 31% from Central or South America, 18% from India, 7% from Haiti, and 3% from other regions.
Methods: Medical examinations were completed at an international adoption clinic soon after arrival into the U. S. (the majority were completed within one month of arrival).
- Physical growth: average growth was not reported for this sample. Physical growth was only reported in relation to other diagnoses.
- Anemia: 17 children (6%) had anemia (hemoglobin <10mmol/liter)
- Other nutritional deficiencies: 1 child was diagnosed with rickets
- Intestinal parasites: 14% were diagnosed with intestinal parasites. Risk factors for infection included being older at adoption, coming from a country other than Korea, and having low weight for age.
Conclusions & Clinical Implications: Intestinal parasites were common, 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. Intestinal parasites were associated with being adopted from regions other than Korea, older age at arrival, and lower weight for age. Approximately 6% had anemia, and rickets was rare (only one child had rickets).
Limitations of the Nutritional Results: It was not reported whether the anemia was due to iron deficiency or another etiology. This study was also undertaken 20 years ago and may not represent the current health of similar children.
Reference: Hostetter MK, Iverson S, Thomas W, McKenzie D, Dole K, Johnson DE. Medical evaluation of internationally adopted children. New England Journal of Medicine. 1991; 325 (7) : 479-485. http://www.ncbi.nlm.nih.gov/pubmed/1649404