title: Medical diagnoses and growth of children residing in Russian orphanages.
abstract: OBJECTIVE
  Survey the health of young children residing in Russian orphanages.
  
  
  METHODS
  Retrospective chart review of all 193 'healthy' young children (105M:88F, age range 2-72 months) residing in orphanages in Murmansk, Russia.
  
  
  RESULTS
  Mothers of these institutionalized children had complex histories including chronic health problems (38%), use of tobacco (41%), alcohol (39%) and illicit drugs (7%). Frequent diagnoses of the children included rickets (21%), foetal alcohol syndrome (10%), anemia (6%), developmental delay (11% mild, 25% moderate, 28% severe), behavioural problems (60%) and 'perinatal encephalopathy' (46%<1 year of age). At orphanage entry, growth delays were common (underweight 34%, short stature 25%, microcephaly 34%). During orphanage residence, height z scores further decreased (p=0.01), but head circumference improved (p<0.0001, paired t-tests). Head circumferences increased significantly in 62% of microcephalic children. Smaller children (z score<-2) at entry exhibited more rapid growth (z score/month) for weight (+0.24 vs. -0.12, p=0.04), height (+0.81 vs. -0.65, p=0.0001), and head circumference (+1.02 vs. -0.10, p=0.0004). Growth correlated with child developmental status.
  
  
  CONCLUSIONS
  Young institutionalized children in Murmansk have complex medical status, social histories and frequent growth and developmental delays. Anthropometric measurements-particularly head circumference-improved during orphanage residence in children who entered with more severe growth delays.
authors.affiliation: International Adoption Clinic, Tufts-New England Medical Center, Boston, MA 02111, USA. lmiller@tufts-nemc.org
authors.forename: Laurie C
authors.initials: LC
authors.lastname: Miller
authors.forename: Wilma
authors.initials: W
authors.lastname: Chan
authors.forename: Aina
authors.initials: A
authors.lastname: Litvinova
authors.forename: Arkady
authors.initials: A
authors.lastname: Rubin
authors.forename: Linda
authors.initials: L
authors.lastname: Tirella
authors.forename: Sharon
authors.initials: S
authors.lastname: Cermak
mesh_terms: D000293:Adolescent; D000328:Adult; D000740:Anemia / Q000453:epidemiology; D049628:Body Size; D002508:Cephalometry; D002648:Child; D002653:Child Behavior Disorders / Q000453:epidemiology; D002674:Child, Institutionalized / Q000706:statistics & numerical data*; D002675:Child, Preschool; D002658:Developmental Disabilities / Q000453:epidemiology*; D005260:Female; D063647:Fetal Alcohol Spectrum Disorders / Q000453:epidemiology; D006130:Growth Disorders / Q000453:epidemiology*; D006306:Health Surveys; D006801:Humans; D007223:Infant; D008297:Male; D018811:Maternal Exposure / Q000706:statistics & numerical data; D019372:Orphanages; D011247:Pregnancy; D012189:Retrospective Studies; D012279:Rickets / Q000453:epidemiology; D012426:Russia / Q000453:epidemiology