Screen International Adoptees for Low Vitamin D

Globally, millions of children lack clean water, adequate food, and the basics of sustenance. Because of this, they often contract infections and develop health problems.

Although controversial, intercountry or international adoptions help children in struggling nations find homes that can provide for them. Medical screening at entry to an adoptee’s new home country is necessary to identify and correct malnutrition and other diagnoses that can be corrected. Some studies have looked at adoptees’ general health status, and a few have found that 21% to 33% of internationally adopted children have hypovitaminosis D.

Researchers in Italy, a country in which 42,000 international adoptees reside, evaluated vitamin D to identify possible risk factors for hypovitaminosis D. Their results appear in the online journal PLOS One.

They analyzed 25-hydroxyvitamin D [25(OH)D] levels in international adoptees during a 4-year period. They screened for severe vitamin D deficiency [serum 25(OH)D levels <10 ng/mL], vitamin D deficiency (serum levels <20 ng/mL), and hypovitaminosis D (serum levels <30 ng/mL) in 962 children.

The average age of the children was 5.5 years. Three-quarters of them had hypovitaminosis D, and 40% had vitamin D deficiency. Approximately 10% had severe vitamin D deficiency.

Children adopted from Ethiopia, Peru, India, Bulgaria, and Lithuania were at significantly higher risk for hypovitaminosis D than others, with more than 90% of these adoptees affected. Age 6 years or older, residence in Italy for fewer than 3 months, and laboratory sample drawn in a season other than summer also increased the likelihood of hypovitaminosis D. Samples drawn in winter and spring were much more likely to reflect a vitamin D deficit.

Other studies conducted in international adoptees who found homes in the United States have reflected lower rates of hypovitaminosis D. These researchers indicate that differences in the study population’s average age and length of time in a new country may explain the differences.

The researchers urge early evaluation of all internationally adopted children for vitamin D status.