东欧领养儿童领养时的体格发育评估及生长发育迟缓的决定因素
Auxological evaluation and determinants of growth failure at the time of adoption in Eastern European adoptees.
作者信息
Miller Bradley S, Kroupina Maria G, Iverson Sandra L, Masons Patrick, Narad Christine, Himes John H, Johnson Dana E, Petryk Anna
机构信息
Department of Pediatrics, University of Minnesota, Minneapolis, MN 55455, USA.
出版信息
J Pediatr Endocrinol Metab. 2009 Jan;22(1):31-9. doi: 10.1515/jpem.2009.22.1.31.
AIM
To identify factors contributing to growth failure in international adoptees (IAs) from Eastern Europe.
STUDY DESIGN
138 IAs from Eastern Europe, 6-59 months old, were evaluated within 3 weeks of US arrival. Complete history, anthropometry, and serum for growth factors were obtained. Facial features were examined for risk of prenatal alcohol exposure.
RESULTS
Upon arrival, mean height (-1.23 +/- 1.07), weight (-1.43 +/- 1.29), and occipitofrontal circumference (OFC) (-0.63 +/- 1.10) SDS in IAs were significantly less than population means for US children. In a multiple regression model, age, low birth weight (LBW), insulin-like growth factor binding protein-3, and high risk for fetal alcohol syndrome were independent predictors of height SDS. LBW also independently predicted lower weight SDS and smaller OFC SDS.
CONCLUSIONS
We recommend that IAs undergo screening upon US arrival to identify risk factors for poor growth, particularly evidence of LBW and fetal alcohol exposure. Catch-up growth should be monitored in all children following adoption.
目的
确定导致来自东欧的国际领养儿童（IA）生长发育迟缓的因素。
研究设计
对138名年龄在6至59个月的来自东欧的国际领养儿童在抵达美国后3周内进行评估。获取完整病史、人体测量数据以及生长因子血清样本。检查面部特征以评估产前酒精暴露风险。
结果
抵达时，国际领养儿童的平均身高（-1.23±1.07）、体重（-1.43±1.29）和枕额周长（OFC）（-0.63±1.10）标准差得分（SDS）显著低于美国儿童的总体均值。在多元回归模型中，年龄、低出生体重（LBW）、胰岛素样生长因子结合蛋白-3以及胎儿酒精综合征高风险是身高标准差得分的独立预测因素。低出生体重还独立预测了更低的体重标准差得分和更小的枕额周长标准差得分。
结论
我们建议国际领养儿童在抵达美国时接受筛查，以确定生长发育不良的风险因素，尤其是低出生体重和胎儿酒精暴露的证据。领养后的所有儿童均应监测追赶生长情况。
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