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Mousikou M, Kyriakou A, Skordis N. Stress and Growth in Children and Adolescents. Horm Res Paediatr 2023; 96:25-33. [PMID: 34814153 DOI: 10.1159/000521074] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 11/19/2021] [Indexed: 11/19/2022] Open
Abstract
The infantile, childhood, and adolescent periods of growth and development also represent times of increased vulnerability to stressors. Growth velocity in each period is dependent on the interplay of genetic, environmental, dietary, socioeconomic, developmental, behavioral, nutritional, metabolic, biochemical, and hormonal factors. A stressor may impact growth directly through modulation of the growth hormone axis or indirectly through other factors. The adaptive response to stressors culminates in behavioral, physiological, and biochemical responses which together support survival and conservation of energy. The immediate response involves activation of the sympathetic nervous system and the hypothalamic-pituitary-adrenal axis. The time-limited stress response is at once antigrowth, antireproductive, and catabolic with no lasting adverse consequences. However, chronic activation of the stress system and hypercortisolism have consequential negative impacts on growth, thyroid function, reproduction-puberty, and metabolism. High cortisol suppresses growth hormone-insulin-like growth factor 1, hypothalamic-pituitary-gonadal, and thyroid axes and has been reported to be responsible for an increase in visceral adiposity, a decrease in lean mass, suppression of osteoblastic activity with risk of osteoporosis, and induction of insulin resistance. Early-life adversities, emotional or physical, have been associated with long-term negative physical and mental health outcomes. Existing models of chronic stress corroborate that early-life adversities can affect growth and have consequences in other aspects of well-being throughout the lifespan. Targeted interventions to reduce stress during infancy, childhood, and adolescence can have far-reaching benefits to long-term health as well as attaining adequate growth. In this review, we describe the neuroendocrinology of the stress response, the factors influencing growth, and the impact of chronic stress on growth during critical periods of infancy, childhood, and puberty with particular reference to growth, thyroid, and gonadal axis.
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Affiliation(s)
- Maria Mousikou
- Department of Paediatric Endocrinology, Makarios Children's Hospital, Nicosia, Cyprus
| | - Andreas Kyriakou
- Department of Paediatric Endocrinology, Makarios Children's Hospital, Nicosia, Cyprus
| | - Nicos Skordis
- Division of Pediatric Endocrinology, Paedi Center for Specialized Pediatrics, Nicosia, Cyprus.,School of Medicine, University of Nicosia, Nicosia, Cyprus
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German A, Rubin L, Raisin G, Hochberg Z. Family Size and the Age at Infancy-Childhood Transition Determine a Child's Compromised Growth in Large Families. Front Pediatr 2022; 10:821048. [PMID: 35573956 PMCID: PMC9100426 DOI: 10.3389/fped.2022.821048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 03/31/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Data on growth of Israeli school children show that children from Jewish ultra-orthodox Haredi and Bedouin Arab families have a higher prevalence of stature below the 3rd percentile. While these populations are usually from lower socioeconomic strata, they also have larger families. This study aimed to evaluate if family structure and the timing of a child's infancy-childhood transition (ICT) are central to variations in stature. STUDY DESIGN We analyzed the association between family size, birth order and inter-birth interval with child growth and the age at ICT in 3 groups of children, 148 high birth order children from large families (LF ≥ 6), 118 low birth order children from large families (LF ≤ 3) and 150 children from small families (SF). RESULTS High birth order children from large families were shorter in childhood than children from small families with a difference of 0.5 SDS in length. We found that birth length and birth order explained 35% of the total variance in infancy length whereas ICT age and infancy length explained 72% of the total variance in childhood length. CONCLUSION Infancy and childhood length are compromised in children from large families. As the family grows larger the younger children tend to be shorter. Reduced length gain in the period between infancy to childhood is when growth is most affected.
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Affiliation(s)
- Alina German
- Department of Pediatrics, Haemek Medical Center, Afula, Israel.,The Ruth and Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel
| | - Lisa Rubin
- School of Public Health, University of Haifa, Haifa, Israel
| | - Galiya Raisin
- Faculty of Medicine, Hebrew University, Jerusalem, Israel
| | - Ze'ev Hochberg
- The Ruth and Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel
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Ivey R, Kerac M, Quiring M, Dam HT, Doig S, DeLacey E. The Nutritional Status of Individuals Adopted Internationally as Children: A Systematic Review. Nutrients 2021; 13:245. [PMID: 33467102 PMCID: PMC7829835 DOI: 10.3390/nu13010245] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 01/12/2021] [Accepted: 01/14/2021] [Indexed: 12/12/2022] Open
Abstract
Since 1955, international adoption has been a way of finding homes for children who have been orphaned or abandoned. We aimed to describe the nutritional status of individuals adopted internationally and their long-term nutritional and health outcomes. We searched four databases for articles published from January 1995 to June 2020, which included information on anthropometric or micronutrient status of children adopted internationally (CAI). Mean Z-scores on arrival to adoptive country ranged from -2.04 to -0.31 for weight for age; -0.94 to 0.39 for weight for height; -0.7 to 0 for body mass index; -1.89 to -0.03 for height for age; -1.43 to 0.80 for head circumference for age. Older children, those adopted from institutionalized care or with underlying disability, were more likely to be malnourished. Though long-term data was scarce, mean Z-scores post-adoption ranged from -0.59 to 0.53 for weight for age; -0.31 to 1.04 for weight for height; 0.39 to 1.04 for body mass index; -1.09 to 0.58 for height for age; -0.06 to 1.23 for head circumference for age. We conclude that though CAI are at high risk of malnutrition at baseline, marked catch-up growth is possible, including for those older than two years of age on arrival. This has implications not only for CAI but for the wider population of malnourished children worldwide. Research on how to optimize catch-up growth is a priority.
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Affiliation(s)
- Richard Ivey
- Department of Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, University of London, London WC1E 7HU, UK; (M.K.); (E.D.)
- Centre for Maternal, Adolescent, Reproductive & Child Health (MARCH), London School of Hygiene & Tropical Medicine, University of London, London WC1E 7HU, UK
| | - Marko Kerac
- Department of Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, University of London, London WC1E 7HU, UK; (M.K.); (E.D.)
- Centre for Maternal, Adolescent, Reproductive & Child Health (MARCH), London School of Hygiene & Tropical Medicine, University of London, London WC1E 7HU, UK
| | - Michael Quiring
- Holt International, Eugene, OR 97401, USA; (M.Q.); (H.T.D.); (S.D.)
| | - Hang T. Dam
- Holt International, Eugene, OR 97401, USA; (M.Q.); (H.T.D.); (S.D.)
| | - Susie Doig
- Holt International, Eugene, OR 97401, USA; (M.Q.); (H.T.D.); (S.D.)
| | - Emily DeLacey
- Department of Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, University of London, London WC1E 7HU, UK; (M.K.); (E.D.)
- Centre for Maternal, Adolescent, Reproductive & Child Health (MARCH), London School of Hygiene & Tropical Medicine, University of London, London WC1E 7HU, UK
- Holt International, Eugene, OR 97401, USA; (M.Q.); (H.T.D.); (S.D.)
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Rogol AD. Emotional Deprivation in Children: Growth Faltering and Reversible Hypopituitarism. Front Endocrinol (Lausanne) 2020; 11:596144. [PMID: 33117295 PMCID: PMC7575787 DOI: 10.3389/fendo.2020.596144] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 09/17/2020] [Indexed: 02/04/2023] Open
Abstract
Emotional deprivation can lead to growth faltering of infants and children. The mechanism(s) involved differ in that for infants, the major metabolic problem is inadequate energy intake for growth. In young children, it is likely that the emotional deprivation causes a syndrome not only of growth faltering, but with bizarre behaviors, especially with regard to food: hoarding, gorging and vomiting, hyperphagia, drinking from the toilet, and eating from garbage pails. Other disturbed behaviors include, poor sleep, night wanderings, and pain agnosia. The pathophysiology appears to be reversible hypopituitarism, at least for the growth hormone and hypothalamic-pituitary- adrenal axes. The review begins with an historical perspective concerning stress, children and growth and then moves to the issue of hospitalism, where young infants failed to thrive (and died) due to inadequate stimulation and energy intake. Refeeding programs at the end of World Wars I and II noted that some children did not thrive despite an adequate energy intake. It appeared that in addition taking care of their emotional needs permitted super-physiologic (catch-up) growth. Next came the first notions from clinical investigation that hypopituitarism might be the mechanism of growth faltering. Studies that address this mechanism from a number of observational and clinical research studies are reviewed in depth to show that the hypopituitarism was relieved upon removal from the deprivational environment and occurred much too quickly to be due to adequate energy alone. These findings are then compared to those from malnourished children and adoptees from emerging countries, especially those from orphanages where their psychosocial needs were unmet despite adequate caloric intake. Together, these various conditions define one aspect of the field of psychoneuroendocrinology.
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Affiliation(s)
- Alan David Rogol
- Department of Pediatrics, University of Virginia, Charlottesville, VA, United States
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Stagi S, Papacciuoli V, Boiro D, Maggioli C, Ndambao NN, Losi S, Chiappini E, Toni S, Ndiaye O. Auxological and endocrinological features in internationally adopted children. Ital J Pediatr 2020; 46:82. [PMID: 32522220 PMCID: PMC7288436 DOI: 10.1186/s13052-020-00832-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Accepted: 05/11/2020] [Indexed: 01/17/2023] Open
Abstract
In internationally adopted children disorders of linear growth, puberty development, thyroid function, and bone metabolism are frequently reported. It is important that these children receive careful auxological and endocrinological evaluations and follow-up.Pediatricians and other healthcare providers should be aware that auxological and endocrinological problems are common in newly arrived international adoptees.
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Affiliation(s)
- Stefano Stagi
- Health Sciences Department, University of Florence, Anna Meyer Children's University Hospital, Viale Pieraccini 24, 50139, Florence, Italy.
| | - Valeria Papacciuoli
- Health Sciences Department, University of Florence, Anna Meyer Children's University Hospital, Viale Pieraccini 24, 50139, Florence, Italy
| | - Djibril Boiro
- Service Universitaire de Pediatrie, UCAD, Dakar, Senegal
| | - Chiara Maggioli
- Health Sciences Department, University of Florence, Anna Meyer Children's University Hospital, Viale Pieraccini 24, 50139, Florence, Italy
| | | | - Stefania Losi
- Health Sciences Department, University of Florence, Anna Meyer Children's University Hospital, Viale Pieraccini 24, 50139, Florence, Italy
| | - Elena Chiappini
- Health Sciences Department, University of Florence, Anna Meyer Children's University Hospital, Viale Pieraccini 24, 50139, Florence, Italy
| | - Sonia Toni
- Health Sciences Department, University of Florence, Anna Meyer Children's University Hospital, Viale Pieraccini 24, 50139, Florence, Italy
| | - Ousmane Ndiaye
- Service Universitaire de Pediatrie, UCAD, Dakar, Senegal
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Gayapersad A, Ombok C, Kamanda A, Tarus C, Ayuku D, Braitstein P. The Production and Reproduction of Kinship in Charitable Children’s Institutions in Uasin Gishu County, Kenya. CHILD & YOUTH CARE FORUM 2019. [DOI: 10.1007/s10566-019-09506-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Holický J, Kokštejn J, Musálek M. Psychomotor development differences between Czech adolescents from orphanages and adolescents from majority society. ACTA GYMNICA 2015. [DOI: 10.5507/ag.2015.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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