Adoption or Placement in Foster Care and Catch-up in Linear Growth and Development: A Meta-Analysis of Individual Participant Data

IF 8 1区医学 Q1 NUTRITION & DIETETICS

Advances in Nutrition Pub Date : 2025-02-22 DOI:10.1016/j.advnut.2025.100395

Jef L Leroy , Moira Donahue Angel , Edward A Frongillo

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引用次数: 0

Abstract

The ability of children to recover from linear growth retardation, often referred to as catch-up growth, has intrigued researchers for many decades. Whether adoption from a low-income to a high-income setting, which provides a comprehensive improvement in the conditions that cause children to not grow well, leads to catch-up growth is unknown. We estimated the association of adoption (or placement in foster care) with catch-up in linear growth and child development before 5 y of age. We conducted a 2-stage meta-analysis using individual participant data for linear growth. We obtained study-specific and subgroup estimates and pooled the estimates using random-effects models. Sensitivity analyses were used to assess the robustness of our findings. A review of child-development outcomes was conducted. We included 485 children under 5 y of age from 9 adoption studies. At baseline, children had a mean age of 15.8 mo and a length deficit of 3.9 cm. Adoption reduced this gap by 77% or 3.0 cm (95% confidence interval [CI]: 1.9, 4.1 cm; mean age: 32.3 mo). Catch-up growth was found in both girls (3.6 cm; 95% CI: 2.9, 4.2 cm) and boys (2.5 cm; 95% CI: 1.9, 3.1 cm) and in children adopted after the age of 24 mo (2.2 cm; 95% CI: 0.6, 3.7 cm). The sensitivity analyses did not change any of the substantive findings. The magnitude of catch-up in child development (mean reduction in deficit of 46%) was smaller than that in linear growth. Catch-up in linear growth in children under 5 is biologically possible when the environment is improved profoundly and comprehensively. Partial reversal of the accumulated height deficit is more likely than recovery in developmental outcomes, which highlights the need to ensure all children grow and develop in environments that prevent deficits from occurring rather than trying to correct them.

This review was registered at PROSPERO as CRD42022298715 (https://www.crd.york.ac.uk/PROSPEROFILES/298715_PROTOCOL_20220429.pdf).

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来源期刊

Advances in Nutrition 医学-营养学

CiteScore

17.40

自引率

2.20%

发文量

117

审稿时长

56 days

期刊介绍： Advances in Nutrition (AN/Adv Nutr) publishes focused reviews on pivotal findings and recent research across all domains relevant to nutritional scientists and biomedical researchers. This encompasses nutrition-related research spanning biochemical, molecular, and genetic studies using experimental animal models, domestic animals, and human subjects. The journal also emphasizes clinical nutrition, epidemiology and public health, and nutrition education. Review articles concentrate on recent progress rather than broad historical developments. In addition to review articles, AN includes Perspectives, Letters to the Editor, and supplements. Supplement proposals require pre-approval by the editor before submission. The journal features reports and position papers from the American Society for Nutrition, summaries of major government and foundation reports, and Nutrient Information briefs providing crucial details about dietary requirements, food sources, deficiencies, and other essential nutrient information. All submissions with scientific content undergo peer review by the Editors or their designees prior to acceptance for publication.