Open Access Clinical Study

Determinants of Catch-Up Growth in International Adoptees from Eastern Europe

Bradley S Miller1, Maria G Kroupina1,2,3, Patrick Mason4, Sandra L Iverson1,2, Christine Narad4, John H Himes5, Dana E Johnson1,2,3 and Anna Petryk1,6*

Author Affiliations

1 Department of Pediatrics, University of Minnesota, Minneapolis, MN 55455, USA

2 International Adoption Medicine, University of Minnesota, Minneapolis, MN 55455, USA

3 Center for Neurobehavioral Development, University of Minnesota, Minneapolis, MN 55455, USA

4 International Adoption Center, Inova Fairfax Hospital for Children, Fairfax, VA 22031, USA

5 Department of Epidemiology, University of Minnesota, Minneapolis, MN 55455, USA

6 Division of Endocrinology, University of Minnesota Children's Hospital, MMC 8404, 13-124 Phillips-Wangensteen Building, SE Minneapolis, MN 55455, USA

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International Journal of Pediatric Endocrinology 2010, 2010:107252 doi:10.1155/2010/107252

Published: 30 November 2010

Abstract

Children raised in orphanages frequently experience growth suppression due to multiple risk factors. Placing such children in more nurturing environments through adoption leads to significant catch-up growth (CUG), the determinants of which are not entirely understood. The goal of this study was to perform an auxological evaluation and examine the degree and correlates of CUG in international adoptees. Children adopted from Eastern Europe, (, 71 males), 7 to 59 months of age, were recruited within 3 weeks of their arrival to the US. At baseline, mean height SDS was and 22% were <−2 SDS for height. IGF-1 and/or IGFBP-3 levels <−2 SDS were present in 32%. CUG, defined as a gain of >+0.5 in height SDS, was seen in 62% of adoptees at 6 months after adoption; 7% of children remained <−2 SDS for height (two had growth hormone deficiency). Growth factors improved in the majority of children. Younger age, greater degree of initial growth failure, and higher caloric intake were significantly associated with improved linear growth in multiple regression models. In summary, most adoptees demonstrate excellent CUG within six months after adoption. If growth failure persists after 6 months of appropriate caloric intake, nutrition-independent causes should be considered.