Prenatal Alcohol Exposure and Neurodevelopmental Disorders in Children Adopted From Eastern Europe

Landgren, Magnus; Svensson, Leif; Strömland, Kerstin; Grönlund, Marita Andersson

doi:10.1542/peds.2009-0712

Cited by 158 publications

(140 citation statements)

References 31 publications

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“…Extant reports about the association between prenatal risk and later indiscriminate behaviors are inconsistent, 4,29 and measurement of prenatal risk is fraught with challenges in children with an institutional history. 30 To date, there is limited evidence indicating an important role for prenatal factors in the genesis of indiscriminate behaviors.…”

Section: Discussionmentioning

confidence: 99%

Indiscriminate Behaviors in Previously Institutionalized Young Children

et al. 2014

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WHAT'S KNOWN ON THIS SUBJECT: Children who have experienced early psychosocial deprivation are at high risk of persistent, socially indiscriminate behaviors. These behaviors may decline slowly with high-quality caregiving but generally are associated with ongoing impairment. WHAT THIS STUDY ADDS:This study suggests that placement in foster care reduces indiscriminate behaviors to an intermediate level between those in institutional care and community control subjects. It also demonstrates the importance of disorganized early attachment in predicting later indiscriminate behaviors. abstract OBJECTIVE: This study included 54-month-old children with a history of institutional care. Our goal was to: (1) examine differences in indiscriminate social behaviors in children with a history of institutional care compared with home-reared children; (2) test whether foster care reduces indiscriminate social behaviors in a randomized controlled trial; and (3) examine early predictors of indiscriminate behaviors. METHODS:Participants were 58 children with a history of institutional care and 31 never-institutionalized control (NIG) subjects enrolled in a randomized controlled trial of foster care for institutional care, assessed from toddlerhood to 54 months. Indiscriminate social behaviors were measured naturalistically by using the Stranger at the Door procedure. RESULTS:In the Stranger at the Door procedure, children with a history of institutional care left with a stranger at higher rates than NIG subjects (33% vs 3.5%; P , .001). Children in the care as usual group left more than NIG subjects (41.9% vs 3.6%; P # .001). The differences between the foster care group (24.1%) and the care as usual group and between foster care group and NIG were not significant. In a logistic regression, early disorganized attachment behaviors, baseline developmental quotient, and caregiving quality after randomization contributed to variance at 54 months. In the same analysis using only children with a history of institutional care, only disorganized attachment contributed significantly to 54-month indiscriminate social behaviors (Exp[B] = 1.6 [95% confidence interval: 1.1-2.5]).CONCLUSIONS: Observed socially indiscriminate behaviors at 54 months were associated with prolonged exposure to institutional care. Young children raised in conditions of deprivation who fail to develop organized attachments as toddlers are at increased risk for subsequent indiscriminate behaviors. Pediatrics 2014;133:e657-e665 AUTHORS:

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Section: Discussionmentioning

confidence: 99%

Indiscriminate Behaviors in Previously Institutionalized Young Children

et al. 2014

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“…Thirty-four articles (representing 33 studies) contained relevant data and were selected for data extraction. A schematic diagram of the search strategy is depicted in Fig 1. Data on the prevalence of FAS and/or FASD in child-care systems were available from only 8 countries, as follows: Brazil (1 study 40 ), Chile (2 studies 41,42 ) Canada (3 studies 4,43,44 ), Israel (1 study 45 ), Russia (10 studies 11,46-55 ), Spain (1 study 56 ), Sweden (3 studies [57][58][59] ), and the United States (USA; 11 studies [60][61][62][63][64][65][66][67][68][69][70] ). One study reported on the prevalence of FAS among preadoption children from Eastern Europe (Romania, Ukraine, Moldova).…”

Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

“…The 2 countries with the highest reported prevalence of FAS among children and youth in child-care settings were Russia 54,55 and Sweden, 58 71 (preadoption children from Romania, Ukraine, Moldova) and the United States 62 (adoptees from China) had a reported prevalence for FAS of 0 per 1000. As with FAS, the 2 countries with the highest reported prevalence of FASD among children and youth in child-care settings were Russia 47 and Sweden, 58 397 per 1000 (orphanage) and 521 per 1000 (adoptees from Eastern Europe), respectively, and 40 per 1000 was reported for Israel 45 (foster care and preadoption children) and the United States 64,68 (adoptees from Eastern Europe).…”

Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

“…As with FAS, the 2 countries with the highest reported prevalence of FASD among children and youth in child-care settings were Russia 47 and Sweden, 58 397 per 1000 (orphanage) and 521 per 1000 (adoptees from Eastern Europe), respectively, and 40 per 1000 was reported for Israel 45 (foster care and preadoption children) and the United States 64,68 (adoptees from Eastern Europe).…”

Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

“…Of those studies that did report the diagnostic system used, 7 studies 44,54-56,59,60,66 used the 4-Digit Diagnostic Code, 24 2 studies 48,58 used the IOM diagnostic criteria, 23 2 studies 47,68 used the CDC FAS Guidelines, 15 1 study 46 used the FASD Study Group criteria, 17 and 1 study 63 used the Smith' s Recognizable Patterns of Human Malformations. 27 One study 45 used a modified version of the IOM diagnostic criteria 23 in combination with a modified version of the Canadian Guidelines, 26 and 1 study 52 used a modified version of the 4-Digit Diagnostic Code 24 along with the FAS Screen.…”

Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

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Prevalence of Fetal Alcohol Spectrum Disorders in Child Care Settings: A Meta-analysis

et al. 2013

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BACKGROUND: Children often enter a child-care system (eg, orphanage, foster care, child welfare system) because of unfavorable circumstances (eg, maternal alcohol and/or drug problems, child abuse/neglect). Such circumstances increase the odds of prenatal alcohol exposure, and thus this population can be regarded as high risk for fetal alcohol spectrum disorders (FASD). The primary objective was to estimate a pooled prevalence for fetal alcohol syndrome (FAS) and FASD in various child-care systems based on data from existing studies that used an active case ascertainment method. METHODS:A systematic literature review, using multiple electronic bibliographic databases, and meta-analysis of internationally published and unpublished studies that reported the prevalence of FAS and/or FASD in all types of child-care systems were conducted. The pooled prevalence estimates and 95% confidence intervals (CIs) were calculated by using the Mantel-Haenszel method, assuming a random effects model. Sensitivity analyses were performed for studies that used either passive surveillance or mixed methods. RESULTS:On the basis of studies that used active case ascertainment, the overall pooled prevalence of FAS and FASD among children and youth in the care of a child-care system was calculated to be 6.0% (60 per 1000; 95% CI: 38 to 85 per 1000) and 16.9% (169 per 1000; 95% CI: 109 to 238 per 1000), respectively. CONCLUSIONS:The results confirm that children and youth housed in or under the guardianship of the wide range of child-care systems constitute a population that is high-risk for FASD. It is imperative that screening be implemented in these at-risk populations.

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Global Prevalence of Fetal Alcohol Spectrum Disorder Among Children and Youth

et al. 2017

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Prevalence estimates are essential to effectively prioritize, plan, and deliver health care to high-needs populations such as children and youth with fetal alcohol spectrum disorder (FASD). However, most countries do not have population-level prevalence data for FASD.OBJECTIVE To obtain prevalence estimates of FASD among children and youth in the general population by country, by World Health Organization (WHO) region, and globally.

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Prenatal Alcohol Exposure and Neurodevelopmental Disorders in Children Adopted From Eastern Europe

Cited by 158 publications

References 31 publications

Indiscriminate Behaviors in Previously Institutionalized Young Children

Indiscriminate Behaviors in Previously Institutionalized Young Children

Prevalence of Fetal Alcohol Spectrum Disorders in Child Care Settings: A Meta-analysis

Global Prevalence of Fetal Alcohol Spectrum Disorder Among Children and Youth

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