Objective Children exposed to institutional rearing often exhibit problems across a broad array of developmental domains. We compared the consequences of long-term high-quality foster care versus standard institution-based care which began in early childhood on cardiometabolic and immune markers assessed at the time of adolescence.
Methods The Bucharest Early Intervention Project is a longitudinal investigation of children institutionalized during early childhood (ages 6 to 30 months at baseline) who were subsequently randomized to either high-quality foster care or continued institutional care. At age 16, 127 respondents participated in a biomarker collection protocol, including 44 institutionalized children randomly assigned to receive care as usual, 41 institutionalized childrenrandomized to be removed from institutional care and placed in high-quality foster care in infancy, and a control group of 42 demographically-matched children raised in biological families. Outcomes included body mass index (BMI), systolic and diastolic blood pressure, C-reactive protein, interleukin (IL)-6, IL-8, IL-10, tumor necrosis factor-α, glycosylated hemoglobin A1c, and Epstein Barr virus antibody titers.
Results Early institutional rearing was not associated with differences in cardiometabolic or immune markers. Randomization to foster care and age of placement into foster care were also unrelated to these markers, with the exception of BMI z-score, where children assigned to care as usual had lower BMI z-scores relative to childrenassigned to foster care (-0.23 vs 0.08, p=0.06), and older age at placement was associated with lower BMI (β=-0.07, p=0.03).
Conclusions The impact of institutional rearing on measures of cardiometabolic health and immune system functioning is either absent, or not evident until later in development. These findings provide new insights into the biological embedding of adversity and how it varies developmentally and across regulatory systems and adversity type.