Skip to main content
SpringerLink
Log in

Auxo-endocrinological features in a cohort of internationally adopted children in Italy

  • Original Article
  • Published:
World Journal of Pediatrics Aims and scope Submit manuscript

Abstract

Background

Internationally adopted children (IAC) can present growth impairment at arrival, which usually recovers over time. Moreover, a major prevalence of precocious puberty has been reported in this group.

Methods

All IAC referred to a tertiary level hospital in Italy from January 2016 to June 2017, underwent a standardized screening protocol and were prospectively enrolled in the study. The analyses of possible risk factors for growth impairment and precocious puberty were performed.

Results

Overall, 422 children were included (males 59.5%), with median age of 6.5 years (IQR 9.4–3.9), 29.9% adopted from Europe, 26.8% from Asia, 23.9% from Africa and 19.4% from Latin America. Children were in Italy from a median of 75 days (IQR 137.0–38.7). Stunting was observed in 12.9% of children, wasting in 4.3%, underweight in 12.9%. Precocious puberty was diagnosed in 2.2% of children. 17.1% IAC had diagnosis of special needs. Fetal alcohol spectrum disorders represented the 41.7% of children with special needs and 48.1% of Russian children. Independent predictive factors for stunting were age < 5 years, a diagnosis of special need and having been living in Italy for < 60 days since the arrival.

Conclusion

Stunting among IAC is a frequent finding especially in children < 5 years and in those with special needs, independently from their geographical origin.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Italian Presidency of the Council of Ministers. Commission for international adoptions. http://www.commissioneadozioni.it/media/155472/reportcai20162017.pdf. Accessed 7 Oct 2018.

  2. Sollai S, Ghetti F, Bianchi L, de Martino M, Galli L, Chiappini E. Infectious diseases prevalence, vaccination coverage, and diagnostic challenges in a population of internationally adopted children referred to a Tertiary Care Children’s Hospital from 2009 to 2015. Medicine (Baltimore). 2017;96:e6300.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Miller LC. Growth and development. In: Miller LC, editor. The handbook of international adoption medicine. A guide for physicians, parents, and providers. Oxford: Oxford University Press; 2005.

    Google Scholar 

  4. Miller BS, Kroupina MG, Iverson SL, Masons P, Narad C, Himes JH, et al. Auxological evaluation and determinants of growth failure at the time of adoption in Eastern european adoptees. J Pediatr Endocrinol Metab. 2009;22:31–9.

    Article  PubMed  Google Scholar 

  5. Van Ijzendoorn MH, Bakermans-Kranenburg MJ, Juffer F. Plasticity of growth in height, weight, and head circumference: meta-analytic evidence of massive catch-up after international adoption. J Dev Behav Pediatr. 2007;28:334–43.

    Article  PubMed  Google Scholar 

  6. Miller BS, Kroupina MG, Mason P, Iverson SL, Narad C, Himes JH, et al. Determinants of catch-up growth in international adoptees from eastern europe. Int J Pediatr Endocrinol. 2010;2010:107252.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Teilmann G, Petersen JH, Gormsen M, Damgaard K, Skakkebaek NE, Jensen TK. Early puberty in internationally adopted girls: hormonal and clinical markers of puberty in 276 girls examined biannually over two years. Horm Res. 2009;72:236–46.

    Article  CAS  PubMed  Google Scholar 

  8. Teilmann G, Pedersen CB, Skakkebaek NE, Jensen TK. Increased risk of precocious puberty in internationally adopted children in Denmark. Pediatrics. 2006;118:e391–9.

    Article  PubMed  Google Scholar 

  9. Soriano-Guillén L, Corripio R, Labarta JI, Cañete R, Castro-Feijóo L, Espino R, et al. Central precocious puberty in children living in Spain: incidence, prevalence and influence of adoption and immigration. J Clin Endocrinol Metab. 2010;95:4305–13.

    Article  CAS  PubMed  Google Scholar 

  10. Parent AS, Teilmann G, Juul A, Skakkebaek NE, Toppari J, Bourguignon JP. The timing of normal puberty and the age limits of sexual precocity: variations around the world, secular trends, and changes after migration. Endocr Rev. 2003;24:668–93.

    Article  PubMed  Google Scholar 

  11. van Ginkel JR, Juffer F, Bakermans-Kranenburg MJ, van IJzendoorn MH. Do internationally adopted children in the Netherlands use more medication than their non-adopted peers? Eur J Pediatr. 2016;175:715–25.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Reid BM, Miller BS, Dorn LD, Desjardins C, Donzella B, Gunnar M. Early growth faltering in post-institutionalized youth and later anthropometric and pubertal development. Pediatr Res. 2017;82:278–84.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Krstevska-Konstantinova M, Charlier C, Craen M, Du Caju M, Heinrichs C, de Beaufort C, et al. Sexual precocity after immigration from developing countries to Belgium: evidence of previous exposure to organochlorine pesticides. Hum Reprod. 2001;16:1020–6.

    Article  CAS  PubMed  Google Scholar 

  14. Hoyme HE, May PA, Kalberg WO, Kodituwakku P, Gossage JP, Trujillo PM, et al. A practical clinical approach to diagnosis of fetal alcohol spectrum disorders: clarification of the 1996 institute of medicine criteria. Pediatrics. 2005;115:39–47.

    Article  PubMed  Google Scholar 

  15. World Health Organization. Training course on child growth assessment. Geneva: WHO; 2008. http://www.who.int/childgrowth/training/module_b_measuring_growth.pdf. Accessed 24 Nov 2017.

    Google Scholar 

  16. Allgrove J, Shaw NJ. A practical approach to vitamin D deficiency and rickets. Endocr Dev. 2015;28:119–33.

    Article  CAS  PubMed  Google Scholar 

  17. Pearce SH, Brabant G, Duntas LH, Monzani F, Peeters RP, Razvi S, et al. 2013 ETA guideline: management of subclinical hypothyroidism. Eur Thyroid J. 2013;2:215–28.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. WHO global database on anemia. World wide prevalence of anemia 1993–2005. Geneva: World Health Organization; 2008. http://apps.who.int/iris/bitstream/10665/43894/1/9789241596657_eng.pdf. Accessed 24 Nov 2017.

  19. WHO AnthroPlus for personal computers manual: software for assessing growth of the world’s children and adolescents. Geneva: WHO; 2009. http://www.who.int/growthref/tools/en/. Accessed 24 Nov 2017.

  20. WHO Multicentre Growth Reference Study Group. WHO child growth standards based on length/height, weight and age. Acta Paediatr Suppl. 2006;450:76–85.

    Google Scholar 

  21. de Onis M, Onyango AW, Borghi E, Siyam A, Nishida C, Siekmann J. Development of WHO growth reference for school-aged children and adolescents. Bull World Health Organ. 2007;85:660–7.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Berberoğlu M. Precocious puberty and normal variant puberty: definition, etiology, diagnosis and current management. J Clin Res Pediatr Endocrinol. 2009;1:164–74.

    Article  PubMed  Google Scholar 

  23. Child and Adolescent Health Measurement Initiative, Data Resource Center on Child and Adolescent Health. National survey of children with special health care needs. https://www.childhealthdata.org/browse/survey/results?q=1792#x26r=1. Accessed 24 Nov 2017.

  24. Mason P, Narad C, Jester T, Parks J. A survey of growth and development in the internationally adopted child. Pediatr Res. 2000;47:209A.

    Google Scholar 

  25. Kroupina MG, Eckerle JK, Fuglestad AJ, Toemen L, Moberg S, Himes JH, et al. Associations between physical growth and general cognitive functioning in international adoptees from Eastern Europe at 30 months post-arrival. J Neurodev Disord. 2015;7:36.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Miller LC, Hendrie NW. Health of children adopted from China. Pediatrics. 2000;105:E76.

    Article  CAS  PubMed  Google Scholar 

  27. Proos LA, Hofvander Y, Wennqvist K, Tuvemo T. A longitudinal study on anthropometric and clinical development of Indian children adopted in Sweden. I. Clinical and anthropometric condition at arrival. Ups J Med Sci. 1992;97:79–92.

    Article  CAS  PubMed  Google Scholar 

  28. Miller LC, Tseng B, Tirella LG, Chan W, Feig E. Health of children adopted from Ethiopia. Matern Child Health J. 2008;12:599–605.

    Article  PubMed  Google Scholar 

  29. Miller L, Chan W, Comfort K, Tirella L. Health of children adopted from Guatemala: comparison of orphanage and foster care. Pediatrics. 2005;115:e710–7.

    Article  PubMed  Google Scholar 

  30. Miller LC, Kiernan MT, Mathers MI, Klein-Gitelman M. Developmental and nutritional status of internationally adopted children. Arch Pediatr Adolesc Med. 1995;149:40–4.

    Article  CAS  PubMed  Google Scholar 

  31. Palacios J, Román M, Camacho C. Growth and development in internationally adopted children: extent and timing of recovery after early adversity. Child Care Health Dev. 2011;37:282–8.

    Article  PubMed  Google Scholar 

  32. Loman MM, Wiik KL, Frenn KA, Pollak SD, Gunnar MR. Postinstitutionalized children’s development: growth, cognitive, and language outcomes. J Dev Behav Pediatr. 2009;30:426–34.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Albers LH, Johnson DE, Hostetter MK, Iverson S, Miller LC. Health of children adopted from the former Soviet Union and Eastern Europe. Comparison with pre-adoptive medical records. JAMA. 1997;278:922–4.

    Article  CAS  PubMed  Google Scholar 

  34. Shay PL, Goldstein JA, Wink JD, Paliga JT, Solot CB, Cohen MA, et al. International adoptees with cleft lip and/or palate: lessons learned from a growing population. Ann Plast Surg. 2016;77:377–82.

    Article  CAS  PubMed  Google Scholar 

  35. Fernandez ID, Himes JH, de Onis M. Prevalence of nutritional wasting in populations: building explanatory models using secondary data. Bull World Health Organ. 2002;80:282–91.

    PubMed  PubMed Central  Google Scholar 

  36. Fuglestad AJ, Georgieff MK, Iverson SL, Miller BS, Petryk A, Johnson DE, et al. Iron deficiency after arrival is associated with general cognitive and behavioral impairment in post-institutionalized children adopted from Eastern Europe. Matern Child Health J. 2013;17:1080–7.

    Article  PubMed  Google Scholar 

  37. Li M, Eastman CJ. The changing epidemiology of iodine deficiency. Nat Rev Endocrinol. 2012;8:434–40.

    Article  CAS  PubMed  Google Scholar 

  38. Hayes P, Tan TX. Timing of menarche in girls adopted from China: a cohort study. Child Care Health Dev. 2016;42:859–62.

    Article  CAS  PubMed  Google Scholar 

  39. Baron S, Battin J, David A, Limal JM. Precocious puberty in children adopted from foreign countries. Arch Pediatr. 2000;7:809–16 (in French).

    Article  CAS  PubMed  Google Scholar 

  40. Hayes P. International adoption, “early” puberty, and underrecorded age. Pediatrics. 2013;131:1029–31.

    Article  PubMed  Google Scholar 

Download references

Funding

None.

Author information

Authors and Affiliations

  1. Department of Health Sciences, University of Florence, Anne Meyer Children’s University Hospital, Florence, Italy

    Barbara Bortone, Camilla Totaro, Pasqua Putignano, Sara Sollai, Luisa Galli, Maurizio de Martino & Elena Chiappini

  2. Department of Pediatrics, Anne Meyer Children’s University Hospital, Viale Pieraccini, 24, 50100, Florence, Italy

    Elena Chiappini

Authors
  1. Barbara Bortone
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Camilla Totaro
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Pasqua Putignano
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Sara Sollai
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Luisa Galli
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Maurizio de Martino
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Elena Chiappini
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

BB conceived the original idea, contributed to the analysis of the results and wrote the manuscript. CT and PP contributed to the data collection. SS contributed to the data collection and supervised the project. LG and MM supervised the project and critically revised the manuscript. EC conceived the original idea, contributed to the analysis of the results, supervised the project, and critically revised the manuscript. All authors approved the final version of the manuscript.

Corresponding author

Correspondence to Elena Chiappini.

Ethics declarations

Ethical approval

The study was approved by the Ethics Committee for Human Investigation at the Meyer Children University Hospital.

Conflict of interest

Authors declare no conflict of interest relatively to the topic of this article. No financial or nonfinancial benefits have been received or will be received from any party related directly or indirectly to the subject of this article.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic supplementary material

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Bortone, B., Totaro, C., Putignano, P. et al. Auxo-endocrinological features in a cohort of internationally adopted children in Italy. World J Pediatr 15, 297–305 (2019). https://doi.org/10.1007/s12519-019-00233-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12519-019-00233-7

Keywords

Search

Navigation