Department of Women's & Children's Health, Uppsala University, Uppsala, Sweden.
Indian J Med Res. 2009 Nov;130(5):646-50.
More than 6800 children from India have been adopted in Sweden over the last four decades. At arrival many were undernourished and suffered from infectious diseases. Catch-up growth was common. Unexpectedly, cases of early pubertal development were subsequently reported. In order to investigate the growth and development of adopted children more in detail we studied 114 children adopted from India prospectively during two years. The majority were stunted at arrival and caught up in height and weight after two years. Psychomotor retardation and common infections diminished fairly soon. Those that were stunted did not attain the higher catch-up levels of those not stunted at arrival. Low birthweight also limited the degree of catch-up growth. 107 girls were analysed retrospectively in another study. The median menarcheal age was 11.6 yr (range 7.3-14.6 yr) which is significantly earlier than the mean in Swedish and privileged Indian girls (13.0 and 12.4-12.9 yr, respectively). The pubertal linear growth component was normal in duration and magnitude but likewise started 1.5 yr earlier. The final height/age was 154 cm (-1.4 SDS) and the weight/age 46.9 kg (-1.1 SDS) 8 per cent were 145 cm or shorter. Stunting limited catch-up growth and final height. Those that were most stunted at arrival, and had the fastest catch-up growth, had the earliest menarche. Good maternal and child nutrition is necessary for full expression of a child's growth potential. What is lost in growth early in life can only partially be recovered by catch-up growth. Such growth is associated with risk for early pubertal development which abbreviates the childhood growth period and limits final height. The mechanism underlying the early pubertal development, and the optimal management of nutrition rehabilitation after chronic malnutrition, need to be clarified by further studies.
在过去的四十年中，超过 6800 名印度儿童在瑞典被收养。抵达时，许多儿童营养不良，患有传染病。追赶生长很常见。出乎意料的是，随后报告了早期青春期发育的病例。为了更详细地研究被收养儿童的生长发育情况，我们前瞻性地研究了在两年内从印度收养的 114 名儿童。大多数儿童在抵达时身材矮小，两年后身高和体重均有所增加。精神运动发育迟缓症和常见感染很快就减少了。那些身材矮小的人没有达到那些在抵达时没有矮小的人的更高追赶水平。低出生体重也限制了追赶生长的程度。在另一项研究中，我们回顾性地分析了 107 名女孩。月经初潮年龄中位数为 11.6 岁（范围 7.3-14.6 岁），明显早于瑞典和特权印度女孩的平均值（分别为 13.0 岁和 12.4-12.9 岁）。青春期线性生长成分持续时间和幅度正常，但同样提前 1.5 年开始。最终身高/年龄为 154 厘米（-1.4 SDS），体重/年龄为 46.9 公斤（-1.1 SDS），8%的人身高为 145 厘米或更矮。身材矮小限制了追赶生长和最终身高。那些在抵达时最矮小、追赶生长最快的人，月经初潮最早。良好的母婴营养对充分发挥儿童的生长潜力是必要的。生命早期失去的生长只能部分通过追赶生长来恢复。这种生长与青春期早期发育的风险相关，青春期早期发育缩短了儿童生长周期并限制了最终身高。需要通过进一步研究来阐明青春期早期发育的机制以及慢性营养不良后营养康复的最佳管理。
