Physical growth delays and stress dysregulation in stunted and non-stunted Ukrainian institution-reared children.

To study the effect of institutional rearing on physical growth and stress regulation we examined 16 institution-reared children (3-6 years old) in Ukraine and compared them with 18 native family-reared children pair-matched on age and gender. Physical growth trajectories were examined on the basis of archival medical records and current measurements of height, weight, and head circumference. Stress regulation was studied on the basis of diurnal salivary cortisol sampled six times during 1 day. 31% of institution-reared children were stunted at 48 months whereas none of the family-reared children were. Substantial delays in physical growth were observed in institution-reared children especially during the first year of life. From 24 months onwards a tendency for improvement in physical growth was evident among the temporarily stunted institution-reared children, with complete catch-up in weight and partial catch-up in height by the time of assessment. Chronically stunted institution-reared children demonstrated persistent severe growth delays. Institution-reared and family-reared children showed similar patterns of diurnal cortisol production with decreases over the day. However, temporarily stunted institution-reared children had a significantly higher total daily cortisol production than both chronically stunted institution-reared children and family-reared children. These data confirm previous findings regarding physical growth delays and stress dysregulation associated with institutional care, but also point to differences in cortisol production between stunted and non-stunted institution-reared children.