Buonsenso Danilo, Pierucci Ugo Maria, Camporesi Anna, Raffaelli Francesca, Barbieri Maria Chiara, Scarlato Lucia, Colonna Arianna Turriziani, Iademarco Mariella, Lazzareschi Ilaria, Valentini Piero
Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A Gemelli IRCCS, Largo A. Gemelli 8, Rome, 00168, Italy.
Area Pediatrica, Dipartimento Di Scienza Della Vita E Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italia.
Ital J Pediatr. 2025 Mar 25;51(1):99. doi: 10.1186/s13052-025-01944-6.
Adoptive children, who have often experienced inadequate healthcare, malnutrition, and exposure to infectious diseases in their countries of origin, are vulnerable to a range of health problems among which anemia is a major one, potentially leading to long term sequelae. We aimed to investigate the prevalence and risk factors associated with anemia in a cohort of internationally adopted children evaluated at the Pediatric Clinic of the Policlinico Universitario "A. Gemelli" in Rome. between 2007 and 2023.
Retrospective cohort analysis. Demographic and hematological data were collected for each child. Associations between categorical variables was studied with Pearson's or Fisher's test and between quantitative and qualitative variables with Analysis of Variance (ANOVA) with Bonferroni correction. The occurrence of a Hb level inferior to -2SD and that of presenting together Hb Z score < -2SD for and low ferritin have been considered as a binary outcome and studied with multivariable logistic regression models.
Nine hundred and sixty-nine children have been enrolled. Weight and height were significantly lower in children from Asia and India compared to Africa and Latin America. Hb z-scores were significantly lower in the 11-18 age group compared to all other age groups. In univariate analysis, Hb z-scores were associated with black skin color and the presence of parasites in stool. Hemoglobin levels were not associated with patient BMI, creatinine levels, bilirubin, TSH, FT3, FT4, AST, or ALT. The mean corpuscular volume (MCV) was associated in univariate analysis with age at arrival, skin color, Macro-area of origin, duration of institutional stay, iron levels. At same MCV, Hb was higher in Asia compared to Africa (p < 0.001). 55 patients had both Hb and MCV values below two SD. These patients are predominantly characterized by black skin color and originating from Africa and India.
There is possibly a complex interplay between environmental exposures and genetic predispositions in shaping the health outcomes of adopted children. Healthcare providers who care for internationally adopted children should prioritize comprehensive health assessments that include screening for anemia, nutritional deficiencies, and parasitic infections.
领养儿童在其原籍国往往经历医疗保健不足、营养不良和接触传染病的情况，容易出现一系列健康问题，其中贫血是主要问题之一，可能导致长期后遗症。我们旨在调查2007年至2023年间在罗马“阿·杰梅利”大学综合医院儿科诊所接受评估的一组国际领养儿童中贫血的患病率及其相关危险因素。
回顾性队列分析。收集每个儿童的人口统计学和血液学数据。分类变量之间的关联采用Pearson检验或Fisher检验进行研究，定量和定性变量之间的关联采用方差分析（ANOVA）并进行Bonferroni校正。血红蛋白水平低于-2SD以及同时出现血红蛋白Z评分< -2SD和低铁蛋白的情况被视为二元结局，并采用多变量逻辑回归模型进行研究。
共纳入969名儿童。与非洲和拉丁美洲的儿童相比，来自亚洲和印度的儿童体重和身高明显较低。11 - 18岁年龄组的血红蛋白Z评分明显低于所有其他年龄组。在单变量分析中，血红蛋白Z评分与黑色肤色和粪便中寄生虫的存在有关。血红蛋白水平与患者的体重指数、肌酐水平、胆红素、促甲状腺激素、游离三碘甲状腺原氨酸、游离甲状腺素、天冬氨酸转氨酶或丙氨酸转氨酶无关。在单变量分析中，平均红细胞体积（MCV）与到达时的年龄、肤色、原籍大区、机构停留时间、铁水平有关。在相同的MCV水平下，亚洲儿童的血红蛋白水平高于非洲儿童（p < 0.001）。55名患者的血红蛋白和MCV值均低于两个标准差。这些患者主要特征为黑色肤色，来自非洲和印度。
在塑造领养儿童的健康结局方面，环境暴露和遗传易感性之间可能存在复杂的相互作用。照顾国际领养儿童的医疗服务提供者应优先进行全面的健康评估，包括贫血、营养缺乏和寄生虫感染的筛查。
