Auxological evaluation and determinants of growth failure at the time of adoption in Eastern European adoptees

Aim: To identify factors contributing to growth failure in international adoptees (IAs) from Eastern Europe. Study design: 138 IAs from Eastern Europe, 6-59 months old, were evaluated within 3 weeks of US arrival. Complete history, anthropometry, and serum for growth factors were obtained. Facial features were examined for risk of prenatal alcohol exposure. Results: Upon arrival, mean height (-1.23 ± 1.07), weight (-1.43 ± 1.29), and occipitofrontal circumference (OFC) (-0.63±1.10) SDS in las were significantly less than population means for US children. In a multiple regression model, age, low birth weight (LBW), insulin-like growth factor binding protein-3, and high risk for fetal alcohol syndrome were independent predictors of height SDS. LBW also independently predicted lower weight SDS and smaller OFC SDS. Conclusions: We recommend that IAs undergo screening upon US arrival to identify risk factors for poor growth, particularly evidence of LBW and fetal alcohol exposure. Catch-up growth should be monitored in all children following adoption.