从俄罗斯收养的女孩的生长和青春期发育:12 年的跟踪调查

Gonzalo Oliván
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摘要

导言:目的是提供纵向生长数据,并确定从俄罗斯收养的女孩的初潮和月经初潮年龄。材料与方法:对 2002-2010 年期间在西班牙收养的 24 名俄罗斯女孩进行了为期 12 年的前瞻性队列研究。我们通过查阅收养前的医疗记录,收集了她们童年的不良经历。我们记录了体重、身高和头围的标准化测量值,以及初潮和月经初潮的年龄。将平均值与参考标准进行比较。结果主要病史:早产(33.3%)、出生体重不足(41.7%)、产前饮酒(45.8%)、虐待和忽视(54.2%)。初步评估:平均年龄 3 岁(标准差 [SD] 1.6);体重 z 值(z)-1.35;身高 z 值-2.42;头围 z 值-1.77。采用该方法一年后,体重(z +0.68)、身高(z +0.98)和头围(z +0.76)均有明显的追赶性增长。生长的时间趋势:体重从 7 岁起没有延迟;身高在 10 岁前持续恢复(z -0.40),并在 15 岁前保持稳定(z -0.46);与体重相比,每个时间点的延迟都更大。月经初潮的平均年龄为 9.9 岁(SD 0.8),身高 135.4 厘米(z -0.43)。月经初潮的平均年龄为 11.9 岁(标准差 0.7),身高为 147.6 厘米(z -0.44)。结论:生长发育模式的特点是:收养时线性生长严重延迟,体重和头围中度延迟,追赶性生长迅速、显著且持续时间长,青春期发育加速,月经初潮和初潮提前,线性生长未完全恢复。
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Growth and pubertal development in girls adopted from Russia: 12-year follow-up
Introduction: the objectives were to provide longitudinal data on growth and determine the age of thelarche and menarche in girls adopted from Russia. Material and methods: prospective cohort study in 24 girls from Russia adopted in Spain in the 2002-2010 period, who were followed up for 12 years. The history of adverse childhood experiences was collected by reviewing pre-adoption medical records. We recorded standardised measurements of weight, height and head circumference and the age at thelarche and menarche. The mean values were compared with reference standards. Results: Salient history: preterm birth (33.3%), low birth weight (41.7%), prenatal alcohol exposure (45.8%), abuse and neglect (54.2%). Initial evaluation: mean age, 3 years (standard deviation [SD] 1.6) years; weight z-score (z), −1.35; height z, −2.42; head circumference z −1.77. One year after adoption, there was significant catch-up growth in weight (z +0.68), height (z +0.98), and head circumference (z +0.76). Temporal trends in growth: no weight delay from age 7 years; height continued to recover until age 10 (z −0.40) and remained stable until age 15 (z −0.46); the delay was greater compared to weight at every timepoint. The mean age at onset of thelarche was 9.9 years (SD 0.8) with a height of 135.4 cm (z −0.43). The mean age at menarche was 11.9 years (SD 0.7) years, with a height of 147.6 cm (z −0.44). Conclusions: the pattern of growth and development was characterized by severe delay in linear growth and a moderate delay in weight and head circumference at the time of adoption, rapid, significant and prolonged catch-up growth, acceleration of pubertal development with early thelarche and menarche and an incomplete recovery of linear growth.
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