Medical diagnoses and growth of children residing in Russian orphanages

Department of Occupational Therapy, Boston University, Boston, Massachusetts, United States
Acta Paediatrica (Impact Factor: 1.67). 12/2007; 96(12):1765-9. DOI: 10.1111/j.1651-2227.2007.00537.x
Source: PubMed


Survey the health of young children residing in Russian orphanages.
Retrospective chart review of all 193 'healthy' young children (105M:88F, age range 2-72 months) residing in orphanages in Murmansk, Russia.
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.
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.

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    • "Studies reporting on prevalence of FASD In total , 17 studies reported the prevalence of FASD in differ - ent populations of Russia ( see , for example , Warren et al . , 2001 ; Riley et al . , 2003 ; Grigovich et al . , 2006 ; Miller et al . , 2007 ; Malakhova et al . , 2008 ; Konovalova et al . , 2009 ) ( Supplementary material , Table S1 ) . The prevalence of FAS in the general population was estimated in one study to be 18 – 19 per 1000 live births ( Malakhova , 2012 ) . However , a study of 326 kindergarten - aged children of the same area did not report any cases of FAS ( Bub"
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    • "MDA 0.5%, POL 0.5%, ROU 5%, RUS 10.5%, SVK 1%, UKR 1%), South America 21.5% (BOL 0.5%, BRA 1%, COL 9%, ECU 1%, GTM 8.5%, PRY 1%, SLV 0.5%), Asia 57% (CHN 11.5%, IND 7.5%, KHM 0.5%, KOR 34.5%, PHL 1.5%, VNM 1.5%), Africa 0.5% (ETH 0.5%) USA Miller et al 69 2004–2007 "
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    ABSTRACT: Background: Children often enter a child-care system (eg, orphanage, foster care, child welfare system) because of unfavorable circumstances (eg, maternal alcohol and/or drug problems, child abuse/neglect). Such circumstances increase the odds of prenatal alcohol exposure, and thus this population can be regarded as high risk for fetal alcohol spectrum disorders (FASD). The primary objective was to estimate a pooled prevalence for fetal alcohol syndrome (FAS) and FASD in various child-care systems based on data from existing studies that used an active case ascertainment method. Methods: A systematic literature review, using multiple electronic bibliographic databases, and meta-analysis of internationally published and unpublished studies that reported the prevalence of FAS and/or FASD in all types of child-care systems were conducted. The pooled prevalence estimates and 95% confidence intervals (CIs) were calculated by using the Mantel-Haenszel method, assuming a random effects model. Sensitivity analyses were performed for studies that used either passive surveillance or mixed methods. Results: On the basis of studies that used active case ascertainment, the overall pooled prevalence of FAS and FASD among children and youth in the care of a child-care system was calculated to be 6.0% (60 per 1000; 95% CI: 38 to 85 per 1000) and 16.9% (169 per 1000; 95% CI: 109 to 238 per 1000), respectively. Conclusions: The results confirm that children and youth housed in or under the guardianship of the wide range of child-care systems constitute a population that is high-risk for FASD. It is imperative that screening be implemented in these at-risk populations.
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