Fuglestad Anita J, Kroupina Maria G, Johnson Dana E, Georgieff Michael K
Department of Psychology, University of North Florida, Jacksonville, FL, USA.
Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA.
Acta Paediatr. 2016 Feb;105(2):e67-76. doi: 10.1111/apa.13234. Epub 2015 Nov 17.
To assess the status of nutrients relevant for brain development in internationally adoptees from disparate global regions and determine whether identified deficiencies are associated with neurodevelopment.
Participants included children adopted from Post-Soviet States (n = 15), Ethiopia (n = 26) or China (n = 17), ages 8-18 months. A comprehensive nutritional battery and a neurodevelopmental assessment were completed at baseline (within one month of arrival) and follow-up (six months later).
At baseline, 35% were stunted, and 68% had at least one abnormal nutritional biochemical marker. The most common were low retinol-binding protein (33%), zinc deficiency (29%), vitamin D insufficiency/deficiency (21%), and iron deficiency (15%). There was significant catch-up growth in height and weight at follow-up, but little improvement in micronutrient deficiencies. Iron deficiency was associated with lower cognitive scores on the Bayley Scales of Infant Development-III, p = 0.027, and slower speed of processing, p = 0.012. Zinc deficiency was associated with compromised memory functioning, p = 0.001.
Nutrient deficiencies were common during the early adoption period in internationally adoptees from three global regions, and iron and zinc deficiencies were associated with poorer neurodevelopmental outcomes. Results emphasise the importance of monitoring micronutrient status at arrival and during the early adoption period, irrespective of country of origin.
评估来自不同全球区域的国际收养儿童中与大脑发育相关的营养状况,并确定所发现的营养缺乏是否与神经发育有关。
参与者包括从后苏联国家(n = 15)、埃塞俄比亚(n = 26)或中国(n = 17)收养的8至18个月大的儿童。在基线(抵达后一个月内)和随访(六个月后)时完成了全面的营养评估和神经发育评估。
在基线时,35%的儿童发育迟缓,68%的儿童至少有一项异常的营养生化指标。最常见的是视黄醇结合蛋白低(33%)、锌缺乏(29%)、维生素D不足/缺乏(21%)和铁缺乏(15%)。随访时身高和体重有显著的追赶性生长,但微量营养素缺乏情况改善不大。铁缺乏与贝利婴幼儿发展量表第三版上较低的认知得分相关(p = 0.027),以及处理速度较慢相关(p = 0.012)。锌缺乏与记忆功能受损相关(p = 0.001)。
来自三个全球区域的国际收养儿童在收养初期营养缺乏情况普遍,铁和锌缺乏与较差的神经发育结果相关。结果强调了在抵达时和收养初期监测微量营养素状况的重要性,无论其原籍国是哪里。