Fetal Alcohol Exposure

Fetal alcohol exposure is common among children adopted from Eastern Europe. Thirty percent of the population may chronically abuse alcohol in the Russian Federation. Per capita adult consumption in 1996 was 38 liters of 100-proof vodka, more than four times higher than the consumption in the United States. The most ominous statistic is a 48.1% increase in the incidence of alcoholism among Russian women during the past decade.

Maternal alcoholism was mentioned in 17% of adoption referral documents, and is particularly common where parental rights were terminated for neglect, abuse, or both. A recent review of 105 Russian adoptees revealed that 43 of 47 maternal histories noted alcohol consumption. However, the incidence of FAS in a group of Eastern European adoptees examined in this country was only 1.6%. This almost certainly underestimates the incidence of alcohol fetopathy in the institutionalized population because not all children with fetal alcohol effects would be identified here, and many children with a history of alcohol exposure and growth failure or other phenotypic characteristics of FAS may be turned down by potential adoptive families or never offered for adoption. In a separate review of 265 sequential referrals from Eastern Europe that were accompanied by a video of the child, 9% had histories, physical features and growth patterns that strongly suggested alcohol exposure in utero. Whichever figures one accepts, an incidence of FAS or fetal alcohol effect between 1.6% and 9% is 9 to 47 times higher than that in the United States or most countries of Western Europe.