Medical diagnoses and growth of children residing in Russian orphanages.
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.
Miller
Laurie C
LC
International Adoption Clinic, Tufts-New England Medical Center, Boston, MA 02111, USA. lmiller@tufts-nemc.org
Chan
Wilma
W
Litvinova
Aina
A
Rubin
Arkady
A
Tirella
Linda
L
Cermak
Sharon
S
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