Children of foreign origin adopted in France. Analysis of 68 cases over 12years at the University Hospital in Tours.

Background. - The number of children of foreign origin adopted in France ha s increased in the past 15 pars. The aim of this study was to analyse disti nctive features and medical problems associated with international adoption . Patients and methods. - The files of 68 foreign-origin adopted children who attended or were admitted to the Medical and Nutrition Unit of the Pediatr ic Hospital in Tours between January Ist 1986 and December 31st 1997, were studied retrospectively. Various parameters were analysed: age at first con sultation, age at adoption, country of origin and health problems, especial ly nutritional status, infectious diseases growth and development. Results. - In the majority of cases, children were adopted before 12 months of age (61.2%), particularly before six months of age (49.3%). The children came m ainly from Africa and countries in the Indian Ocean (48.5%), and from South eastern Asia (33.9%). Malnutrition was frequent in children from Africa. Tw enty-one children (30.9%) prsesented with severe malnutrition characterized by weight less than the mean-2SD for height and required hospitalization. No children had congenital hypothyroidism, hyperphenylalaninemia, nor were HIV positive. Some patients had infectious diseases: II Hepatitis B,four co ngenital syphilis and six tuberculosis, with favourable outcomes after trea tment. The other most frequent diseases were acute diarrhea, chronic diarrh ea, intetinal parasites and scabies, varying according to countries. Three girls adopted from southern Asia developed precocious puberty. Growth and p sychomotor development were satisfactory overall, but abnormalities were ob served in 15 children (22.1%), which is higher than in the general populati on. Conclusion - The expansion of international adoption with distinctive disea ses proves the importance of a checkup as soon as possible after the arriva l of these children in France. This checkup has to include nutritional and general evaluation and supplementary tests, especially for specific serolog y and vaccination status. Following this, it would be possible to propose a suitable follow-up to the adoptive parents. (C) 1999 Editions scientifique s et medicales Elsevier SAS.