Early growth faltering in post-institutionalized youth and later anthropometric and pubertal development

Reid, Brie M.; Miller, Bradley S.; Dorn, Lorah D.; Desjardins, Christopher David; Donzella, Bonny; Gunnar, Megan R.

doi:10.1038/pr.2017.35

Cited by 28 publications

(34 citation statements)

References 41 publications

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“…Cohen's κ was run to determine if there was agreement between the three nurses’ Tanner stage assessment on breast and genital measures in 33 boys and 50 girls. There was almost perfect agreement between the nurses’ assessments, κ = .87, p < .001 using Landis and Koch () criteria of >.81 (more details on Tanner staging in Reid et al., ). Tanner stage was treated continuously in the models described below but dichotomized at a median split (Tanner = 2; grouping 1/2, n = 156, vs. 3/4/5, n = 124) for graphical purposes.…”

Section: Methodsmentioning

confidence: 87%

Pubertal recalibration of cortisol reactivity following early life stress: a cross‐sectional analysis

DePasquale

Donzella

Gunnar

2018

Child Psychology Psychiatry

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Background Children adopted from orphanages or other such institutions tend to display blunted reactivity to stressors – even years after arriving in their generally supportive and highly resourced postadoption homes. Puberty, a proposed sensitive period for environmental influences on stress‐mediating systems, may provide an opportunity for postinstitutionalized children to recalibrate stress response systems in accordance with their now more supportive living situations. Methods This cross‐sectional study examined the hypothalamic‐pituitary‐adrenocortical (HPA)‐axis reactivity of 280 children ages 7 through 14 years; 122 children were adopted from institutions in 14 countries between the ages of 6 months and 5 years, after spending an average of 95% of their lives in institutional care, and 158 children of similarly high socioeconomic status in their biological families served as the nonadopted comparison group. All of the children were assessed by nurses for Tanner stage and, on a different day, completed the Trier Social Stress Test for Children. Results Using a linear mixed‐effects model and seven measures of salivary cortisol, results indicated that early‐pubertal postinstitutionalized children showed blunted HPA axis reactivity compared to nonadopted children, but mid/late‐pubertal postinstitutionalized children displayed higher reactivity similar to the nonadopted comparison children. Conclusions This is the first evidence of possible pubertal recalibration of HPA axis reactivity to a psychosocial stressor in postinstitutionalized children, which provides a promising avenue for future research regarding the protective factors of the postadoption environment and subsequent physiological, behavioral, and psychopathological outcomes.

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Section: Methodsmentioning

confidence: 87%

Pubertal recalibration of cortisol reactivity following early life stress: a cross‐sectional analysis

DePasquale

Donzella

Gunnar

2018

Child Psychology Psychiatry

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“…Although previous work by our group had shown normal BMI in postinstitutionalized youths, 8 we questioned whether more rigorous tests might reveal greater accumulation of fat in the viscera. Nonetheless, although evidence suggests that the physiological mechanisms of catch-up growth promote the accumulation of VAT after nutritional deprivation, 5 this was not observed in these postinstitutionalized youths.…”

Section: Discussionmentioning

confidence: 94%

“…8 This was true also of the 25% of the sample who were severely height-stunted at adoption. 8 However, because body mass index (BMI) is only one measure of metabolic risk, it is possible that postinstitutionalized youths may have higher levels of total body fat and/or a greater degree of fat mass distributed in the visceral adipose tissue (VAT) depots, 9 which may increase cardiovascular risk. 10,11 It is also possible that postinstitutionalized youths have additional metabolic and cardiovascular risks that are not captured by a measure of BMI.…”

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confidence: 81%

Early Life Adversity with Height Stunting Is Associated with Cardiometabolic Risk in Adolescents Independent of Body Mass Index

Reid

Harbin

Arend

et al. 2018

The Journal of Pediatrics

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Objective To evaluate cardiovascular and metabolic function in youths adopted internationally from orphanages/institutions (postinstitutionalized) who were height-stunted at adoption. Study design A total of 30 postinstitutionalized youths (age, 9-18 years; body mass index [BMI] percentile, 7.2-90.4) who were height-stunted at adoption were compared with age- and BMI percentile-matched youths (n = 90). Measurements included total body fat and visceral adipose tissue (dual radiograph absorptiometry), arterial stiffness (augmentation index and pulse wave velocity), cardiac autonomic function (heart rate variability), blood pressure, and fasting lipid, glucose, and insulin levels. Linear regression analyses were computed controlling for parent education, age, trunk tissue fat, height-for-age, sex, and race. Results Compared with controls of the same age, sex, and BMI, the postinstitutionalized children had higher systolic blood pressure (P = .018), augmentation index (P = .033), total cholesterol (P = .047), low-density lipoprotein cholesterol (P = .03), triglycerides (P = .048), insulin (P = .005), and HOMA-IR (P = .01) values. The postinstitutionalized children had a lower low-frequency to high-frequency ratio (P = .008), indicating lower sympathetic tone, as well as a lower total lean mass (P = .016), a lower gynoid lean mass (P = .039), and a higher proportion of trunk tissue fat (P = .017). The postinstitutionalized and control children did not differ in any other body composition measures. Conclusions Early life stress, as represented by height-stunted growth in institutional care, may be associated with early pathways to cardiovascular and metabolic risk in youths even after moving into well-resourced homes early in life and in the absence of increased adiposity. These findings suggest that postinstitutionalized youths with a history of height stunting may need to be closely monitored for emergent cardiometabolic risk factors.

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“…16 In contrast, in children adopted out of adverse environments such as institutional or foster care, many, though not all studies, 15,19 have documented a higher rate of early pubertal development particularly in girls. 10,17 In a longitudinal study of 276 internationally adopted girls to Denmark, the normal probability curves for breast development and menarche were similar in shape to those of typically developing Danish girls but were displaced 1.3 years earlier for both breast development and menarche.…”

Section: Discussionmentioning

confidence: 99%

“…10–12 Many studies have documented catch-up growth over the short term in children placed in more nurturing environments, 10–12 3 longitudinal studies have tracked physical growth through late childhood or adolescence. 13–15 Less is known about how early institutionalization influences pubertal development with reports of delays, 16 accelerations, 10,14,17,18 and null 15,19 effects on various markers of pubertal development in boys and girls.…”

mentioning

confidence: 99%

Caregiving Disruptions Affect Growth and Pubertal Development in Early Adolescence in Institutionalized and Fostered Romanian Children: A Randomized Clinical Trial

Johnson

Tang

Almas

et al. 2018

The Journal of Pediatrics

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Objectives To determine the effects of foster care vs institutional care, as well as disruptions in the caregiving environment on physical development through early adolescence. Study design This was a randomized controlled trial of 114 institutionalized, though otherwise healthy, children from 6 orphanages and 51 never institutionalized control children living in birth families (family care group) in Bucharest, Romania. Children were followed from baseline (21 months, range 5–31) through age 12 years for caregiving disruptions and growth trajectories and through age 14 years for pubertal development. Results Children randomized to the foster care group showed greater rates of growth in height, weight, and body mass index (BMI) through age 12 years than institutionalized group. Tanner development was delayed in institutionalized group boys compared with foster care group and family care group boys at 12 but not 14 years. There were no differences in Tanner development and age of menarche among foster care group, institutionalized group, and family care group girls at ages 12 and 14 years. More disruptions in caregiving between 30 months and 12 years moderated decreases in growth rates of height in foster care group and weight in foster care group and institutionalized group across age. institutionalized group boys with ≥2 disruptions showed lower Tanner scores at age 12 vs institutionalized group and foster care group boys with <2 disruptions. foster care group girls with ≥2 disruptions had higher Tanner scores at age 14 vs foster care group girls with <2 disruptions. Age of menarche was not affected by caregiving disruptions. Conclusions For children who experienced early institutionalization, stable placement within family care is essential to ensuring the best outcomes for physical developmental. Trial registration clinicaltrials.gov: NCT00747396.

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Early growth faltering in post-institutionalized youth and later anthropometric and pubertal development

Cited by 28 publications

References 41 publications

Pubertal recalibration of cortisol reactivity following early life stress: a cross‐sectional analysis

Pubertal recalibration of cortisol reactivity following early life stress: a cross‐sectional analysis

Early Life Adversity with Height Stunting Is Associated with Cardiometabolic Risk in Adolescents Independent of Body Mass Index

Caregiving Disruptions Affect Growth and Pubertal Development in Early Adolescence in Institutionalized and Fostered Romanian Children: A Randomized Clinical Trial

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