Johnson D E, Miller L C, Iverson S, Thomas W, Franchino B, Dole K, Kiernan M T, Georgieff M K, Hostetter M K
International Adoption Clinic, Department of Pediatrics, Minneapolis, MN.
JAMA. 1992;268(24):3446-51.
To determine the medical condition of Romanian adoptees and the effects of the Romanian orphanage system on their health.
Case series.
The international adoption clinics at the University of Minnesota, Minneapolis, and the New England Medical Center, Tufts University, Boston, Mass.
Sixty-five Romanian adoptees who were brought to the United States during a 12-month period beginning in October 1990.
Incidence of hepatitis B, intestinal parasites, tuberculosis, syphilis, human immunodeficiency virus type 1, growth failure, and developmental delay.
Although the adopted children were presumably chosen from the most vital and attractive adoptees, only 15% were judged to be physically healthy and developmentally normal. Fifty-three percent had serological evidence of past or present hepatitis B infection, and 20% of screened children tested positive for hepatitis B surface antigen. In children aged 7 months or older, the overall prevalence of chronic hepatitis B was 23%. Intestinal parasites were found in 33% of subjects, and 45% of infected children had two or more pathogens identified. All the children tested for human immunodeficiency virus type 1 were negative. Two patterns of growth failure were observed that resembled the two subtypes of psychosocial short stature that occur in association with prolonged psychological harassment or emotional deprivation. Infants' length, weight, head circumference, and weight-for-height were adversely affected by institutionalization. Older children's height was reduced. Only 10% of children older than 12 months were developmentally normal.
Romanian adoptees are an extraordinarily high-risk pediatric group as a consequences of decades of government-sanctioned child neglect and abuse.
确定罗马尼亚领养儿童的健康状况以及罗马尼亚孤儿院系统对其健康的影响。
病例系列研究。
明尼阿波利斯市明尼苏达大学以及马萨诸塞州波士顿市塔夫茨大学新英格兰医学中心的国际领养诊所。
1990年10月开始的12个月期间被带到美国的65名罗马尼亚领养儿童。
乙型肝炎、肠道寄生虫、结核病、梅毒、1型人类免疫缺陷病毒的发病率、生长发育迟缓以及发育延迟情况。
尽管这些领养儿童据推测是从最有活力且有吸引力的被领养者中挑选出来的，但只有15%被判定身体健康且发育正常。53%的儿童有过去或现在乙型肝炎感染的血清学证据，20%接受筛查的儿童乙型肝炎表面抗原检测呈阳性。在7个月及以上的儿童中，慢性乙型肝炎的总体患病率为23%。33%的受试者发现有肠道寄生虫，45%受感染儿童被查出有两种或更多种病原体。所有接受1型人类免疫缺陷病毒检测的儿童均为阴性。观察到两种生长发育迟缓模式，类似于因长期心理骚扰或情感剥夺而出现的心理社会矮小症的两种亚型。婴儿的身长、体重、头围以及身高体重比受到机构照料的不利影响。大龄儿童的身高降低。12个月以上的儿童中只有10%发育正常。
由于数十年政府批准的对儿童的忽视和虐待，罗马尼亚领养儿童是一个极高风险的儿科群体。
