THE HEALTH OF CHILDREN ADOPTED FROM ROMANIA
THE HEALTH OF CHILDREN ADOPTED FROM ROMANIA
复制标题
DOI：
10.1001/jama.268.24.3446
复制
发表时间：
1992-12-23
影响因子：
120.7
通讯作者：
HOSTETTER, MK
中科院分区：
文献类型：
--
作者：
JOHNSON, DE;MILLER, LC;HOSTETTER, MK
客观。-确定罗马尼亚被收养者的医疗状况以及罗马尼亚孤儿院系统对他们健康的影响。案件系列.设置. -明尼苏达大学明尼阿波利斯分校的国际收养诊所和马萨诸塞州波士顿塔夫茨大学的新英格兰医疗中心。65名罗马尼亚被收养者在1990年10月开始的12个月内被带到美国。B肝炎、肠道寄生虫、结核病、梅毒、人类免疫缺陷病毒1型、生长障碍和发育迟缓的发病率。虽然被收养的孩子可能是从最有活力和最有吸引力的被收养者中挑选出来的，但只有15%被认为身体健康，发育正常。53%的儿童有过去或现在感染B型肝炎的血清学证据，20%的筛查儿童检测出B型肝炎表面抗原阳性。在7个月或更大的儿童中，慢性B型肝炎的总体患病率为23%。在33%的受试者中发现了肠道寄生虫，45%的感染儿童有两种或两种以上的病原体。所有儿童的人类免疫缺陷病毒1型检测均为阴性。观察到两种生长障碍模式，类似于与长期心理骚扰或情感剥夺相关的两种社会心理矮小亚型。婴儿的身高、体重、头围和身高体重比受到机构化的不利影响。大一点的孩子身高降低了。只有10%的12个月以上的儿童发育正常。罗马尼亚被收养者是一个非常高风险的儿科群体，这是几十年来政府批准的忽视和虐待儿童的结果。
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 consequence of decades of government-sanctioned child neglect and abuse.