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PREVALENCE OF FETAL ALCOHOL SYNDROME AND FETAL ALCOHOL EFFECT IN PRE-ADOPTION EVALUATIONS OF CHILDREN IN RUSSIAN ORPHANAGES
· JE Aronson DO, S Acacha MD, M Alonso, RPAC, Pediatrics, Winthrop-University Hospital, Mineola, New York,USA

Background Fetal Alcohol Syndrome (FAS) which is a worldwide problem with a rate of 1.9 per 1,000 births may cause severe and costly secondary disabilities including mental retardation and behavioral problems. Alcoholism is on the rise in Russia and there are minimal efforts in Russia to provide public health education to prevent alcohol consumption during pregnancy. Most children exposed to alcohol in utero, will not have the facial features consistent with FAS, but may develop behavioral and learning problems consistent with Fetal Alcohol Effect (FAE). According to the Immigration and Naturalization Services of the United States, there will be approximately 3,500 children adopted from Russia in 1997. These children are at increased risk for FAS and FAE.

Objective To determine the prevalence of FAS and FAE in children being evaluated for adoption from Russia
Design/Methods Retrospective chart review in a pediatric ambulatory setting from 1994 through 1997.

Results 131 pre-adoption medical abstracts with accompanying video tapes were evaluated by a pediatrician who specializes in international adoption. 17(13%) medical abstracts included a documented history of maternal alcohol ingestion during pregnancy. Using criteria defined by the Fetal Alcohol Study Group for the Research Society of Alcohol, there were 2 (1.53%) children with FAS. 15 (11%) children were exposed to alcohol and are at risk for FAE. Extrapolating from the number of actually diagnosed FAS cases, would result in a rate of 15 per 1000 births which is eight times the worldwide rate of 1.9 per 1000. The 95% confidence limits for 15 per 1000 live births are as follows: lower limit is 1.9 per 1000 and the upper limit is 54.1 per 1000.

Conclusions Alcohol ingestion during pregnancy is a known health hazard to infants worldwide. The long-term neurodevelopmental, behavioral, and medical complications of FAE and FAS are significant. Pediatricians need to recognize the increased risk of FAE and FAS in children adopted from Russia.
Dr. Jane Ellen Aronson
Winthrop-University Hospital
222 Station Plaza North, Suite 611
Mineola, New York 11501
(516) 663-4417
email: Jaronmink@aol.com

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