Iron Deficiency in International Adoptees from Eastern Europe

Objective

To assess iron deficiency (ID) in international adoptees after adoption.

Study design

Participants (n = 37) were adopted into the United States from Eastern Europe before they were 24 months of age. Baseline (within 1 month post-adoption) and follow-up (6 months post-adoption) assessments included routine post-adoption clinical evaluations, anthropometrics, dietary intakes, and iron measures (hemogram and serum analysis).

Results

At adoption and follow-up, mean percent transferrin saturation and mean corpucuscular volume were low compared with the US population. Mean serum ferritin concentration became lower than the US population at follow-up, although the mean daily iron intake was more than the Recommended Dietary Allowance. Participants with Giardia lamblia at baseline had more compromised iron status at baseline and follow-up. Growth rate (change in z-score/months between assessments) was negatively correlated with change in serum ferritin concentrations between baseline and follow-up (r = −0.34; P < .05).

Conclusions

International adoptees had compromised iron status, with ID more prevalent in participants with G lamblia, a parasite that may interfere with iron absorption. The persistent ID at follow-up was likely caused by the erythropoietic demands of catch-up growth.

Abbreviations: CRP, C-reactive protein, FAS, Fetal alcohol syndrome, Hgb, Hemoglobin, ID, Iron deficiency, IDA, Iron deficiency anemia, MCV, Mean corpuscular volume, NHANES III, Third National Health and Nutrition Examination Survey, RDA, Recommended dietary allowance, RDW, Red cell distribution width, SF, Serum ferritin, %TS, Percent transferrin saturation