FASD Prevention in Russia

Damskaya or "Ladies Vodka" (image via ABC News)

Russia is considered to be a country with one of the highest levels of alcohol consumption in the world. (See the World Health Organization’s Alcohol and Health profile for Russia here). And in a country where rates of alcohol consumption are increasing in general, and in women and youth in particular, it’s interesting to consider the context of FASD prevention.

One report indicates a sharp increase in average alcohol consumption of 80%  between 1990 and 2005. Other reports show increasing consumption among women and young people and suggest that alcohol marketing directed at women is becoming more common. (For more on the latter, you might want to check out the 2008 Reuters article  New ladies’ vodka gives doctors a headache which discusses the release of Damskaya or “Ladies” vodka, targeted at upwardly mobile women and “designed to be sipped with salad after a workout in the gym.”)

The actual rate of FASD in Russia is unknown (not surprising, as official diagnosis is a problem pretty much everywhere) so estimates vary depending on the sample being considered. In a sample of children in orphanages for children with mental health problems in Moscow in 2006, 7.9% of the children were identified as having FASD (186 children out of 2,352). In 2005, in a high risk maternity hospital, the FASD rate was 3.6/1000 live births (which was up from 1.2/1000 in 2004).

A study published last fall by Tatiana Balachova and her colleagues examined drinking patterns among pregnant and non-pregnant women of childbearing age in Russia. They interviewed 648 pregnant and non-pregnant women of childbearing age (18-44) in 7 public women’s clinics in St Petersburg and the Nizhny Novgorod region. They found that:

• 89% of non-pregnant women reported consuming alcohol and 65% reported binge drinking in the past 3 months (binge drinking was defined as 4 or more drinks)
• Women who might become pregnant consumed alcohol similarly to women who were not likely to become pregnant
• There was a significant decline in drinking after women learned they were pregnant – down to 20% of women consuming alcohol
• A high prevalence of binge drinking among women who might become pregnant (e.g., using contraception inconsistently) or who were trying to conceive

Since conducting this survey in 2004-2005, Tatiana Balachova and her colleagues have developed educational materials and online training programs for health care providers and the general public and conducted training for physicians around FASD prevention.

In an interview with Balachova, the reporter commented: “Balachova faced cultural and institutional obstacles to implementing the programs, such as lack of motivation, time constraints of physicians, inadequate training of staff and even the belief that physicians shouldn’t conduct brief interventions. She also encountered misconceptions such as the notion that harm is only caused if parents are intoxicated at conception and the idea that “normal” women don’t drink and are not at risk.”

You can take a look at some of the educational materials they’ve developed on this website (in Russian) and an overview of this work here.

And to wrap up this post, I thought I would mention a resource that was just pointed out to me. Some of you might be familiar with the book Best I Can Be: Living with Fetal Alcohol Syndrome or Effects by Liz Kulp. Well, supporters of the book have translated the book into Russian and Ukrainian and the book can be downloaded for FREE as an e-book from the Braided Cord website.

References

Balachova, T., Bonner, B., Chaffin, M., Bard, D., Isurina, G., Tsvetkova, L. and Volkova, E. (2012), Women’s alcohol consumption and risk for alcohol-exposed pregnancies in Russia. Addiction, 107: 109–117. doi: 10.1111/j.1360-0443.2011.03569.x

Balachova, T. and Varavikova, E. (2008). Preventing FAS/FASD in Russian Children. 1st Central and Eastern European Summit on Preconception Health and Prevention of Birth Defects. August 27-30, 2008. (powerpoint presentation)