The Health of Children Adopted From Romania

Dana E. Johnson

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Child Welfare and Adoption Child Nutrition and Water Access Child and Adolescent Health

Abstract

OBJECTIVE: To determine the medical condition of Romanian adoptees and the effects of the Romanian orphanage system on their health. DESIGN: Case series. SETTING: The international adoption clinics at the University of Minnesota, Minneapolis, and the New England Medical Center, Tufts University, Boston, Mass. PARTICIPANTS: Sixty-five Romanian adoptees who were brought to the United States during a 12-month period beginning in October 1990. MAIN OUTCOME MEASURES: Incidence of hepatitis B, intestinal parasites, tuberculosis, syphilis, human immunodeficiency virus type 1, growth failure, and developmental delay. RESULTS: Although the adopted children were presumably chosen from the most vital and attractive adoptees, only 15% were judged to be physically healthy and developmentally normal. Fifty-three percent had serological evidence of past or present hepatitis B infection, and 20% of screened children tested positive for hepatitis B surface antigen. In children aged 7 months or older, the overall prevalence of chronic hepatitis B was 23%. Intestinal parasites were found in 33% of subjects, and 45% of infected children had two or more pathogens identified. All the children tested for human immunodeficiency virus type 1 were negative. Two patterns of growth failure were observed that resembled the two subtypes of psychosocial short stature that occur in association with prolonged psychological harassment or emotional deprivation. Infants' length, weight, head circumference, and weight-for-height were adversely affected by institutionalization. Older children's height was reduced. Only 10% of children older than 12 months were developmentally normal. CONCLUSION: Romanian adoptees are an extraordinarily high-risk pediatric group as a consequences of decades of government-sanctioned child neglect and abuse.

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1997Determinants of Behavioural Problems in Romanian Children Adopted in Ontario 2009Disinhibited social behavior among internationally adopted children 2007Plasticity of Growth in Height, Weight, and Head Circumference: Meta-analytic Evidence of Massive Catch-up After International Adoption 2010I. INVESTIGATING THE IMPACT OF EARLY INSTITUTIONAL DEPRIVATION ON DEVELOPMENT: BACKGROUND AND RESEARCH STRATEGY OF THE ENGLISH AND ROMANIAN ADOPTEES (ERA) STUDY 1997Health of Children Adopted From the Former Soviet Union and Eastern Europe 1997Offspring-induced nurturance; Animal-human parallels 2009Early childhood stress is associated with elevated antibody levels to herpes simplex virus type 1 2004Emotion understanding in postinstitutionalized Eastern European children

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