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Auxo-endocrinological features in a cohort of internationally adopted children in Italy
Barbara Bortone1, Camilla Totaro1, Pasqua Putignano1
1Department of Health Sciences, University of Florence, Anne Meyer Children's University Hospital, Florence, Italy.
Insights
Growth impairment, specifically stunting, is common in internationally adopted children (IAC), particularly those under five or with special needs. Early arrival in the host country is also a risk factor for stunting in these children.
Area of Science:
- Pediatric Endocrinology
- Global Health
- Child Development
Background:
- Internationally adopted children (IAC) often exhibit growth issues upon arrival, which typically resolve over time.
- A significant incidence of precocious puberty has been documented in this population.
Purpose of the Study:
- To investigate the prevalence of growth impairment and precocious puberty in IAC.
- To identify risk factors associated with growth impairment and precocious puberty in IAC.
Main Methods:
- Prospective enrollment of IAC referred to a tertiary hospital in Italy (January 2016 - June 2017).
- Standardized screening protocol applied to all participants.
- Analysis of risk factors for growth impairment and precocious puberty.
Main Results:
- 422 IAC included, with diverse geographical origins (Europe, Asia, Africa, Latin America).
- Stunting observed in 12.9%, wasting in 4.3%, underweight in 12.9%. Precocious puberty diagnosed in 2.2%.
- Independent predictors for stunting: age < 5 years, special needs diagnosis, and < 60 days in Italy.
Conclusions:
- Stunting is a frequent issue in IAC, especially in children under five and those with special needs.
- Geographical origin does not appear to be an independent factor for stunting in IAC.
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.
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