Study Location: Baltimore, Maryland, USA
Type of Paper: Original Article; Medical Chart Review
Purpose: To describe the health of children at entry into foster care.
- Physical growth: standard anthropometry [height, weight, head circumference (OFC)]. Z scores were calculated using the National Center for Health Statistics.
- Anemia: complete blood cell count
- Serum lead levels
Participants: 1407 children between the ages of 3 days and 18. 8 years at entry into foster care in the U. S. (Baltimore, MD). The average age was 7. 5 years. 29% were younger than 3 years of age at entry.
Methods: Medical examinations were completed within 5 days of entry into foster care.
- Physical growth in children younger than 3 years at entry: The following number of children were below the fifth percentile for growth:
- Height for age (HAZ): 27%
- Weight for age (WAZ): 15%
- Head circumference for age (OFCZ): 19%
- Anemia: 2% of all the children ages 0-18 years were anemic.
- Lead: 3% of the children ages 0-6 years had elevated lead levels.
Conclusions & Clinical Implications: Growth failure was common in children under the age of 3 years at entry into foster care. Three times the expected number of children were below the fifth percentile for weight, more than five times for height, and almost four times for head circumference. There was little anemia or elevated lead levels.
Limitations of the Nutritional Results: The prevalence of anemia may have been low because the paper included all children ages 0 to 18 years old. In general, children under 2 years old are at an increased risk for anemia. The rate of anemia in younger children who are at an increased risk was not reported. 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: Chernoff R, Combs-Orme T, Risley-Curtiss C, Heisler A. Assessing the health status of children entering foster care. Pediatrics. 1994; 93 (4): 594-601. http://www.ncbi.nlm.nih.gov/pubmed/8134214