Understanding Fetal Alcohol Exposure: In a world grappling with the consequences of alcohol abuse, one researcher’s encounter forever changed her career and the lives of countless families she hopes to help. Anna Shchetinina, a doctoral student at the Harvard T.H. Chan School of Public Health, has dedicated her research to exploring the lifelong effects of prenatal alcohol exposure, a field with more questions than answers. Her journey, however, began 15 years ago in a crisis center far from Harvard’s hallowed halls.
A Life-Changing Encounter
The pivotal moment came when a woman, visibly pregnant, intoxicated, and in distress, entered a crisis center in Petrozavodsk, Russia, where Shchetinina was volunteering. She wasn’t alone—she had a 5-year-old daughter with her, and it was clear that they needed help. Over time, the mother sobered up, left her abusive partner, and even secured a job in the medical field. But for Shchetinina, the experience was more profound than she realized then.
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“I didn’t know then that the mother’s drinking could have a lifelong impact on her children, but now I understand that every decision matters, especially during sensitive periods,” she said.
Shchetinina’s work focuses on fetal alcohol spectrum disorder (FASD), a condition entirely preventable but incurable. Its effects can be devastating: cognitive delays, behavioral issues, and physical impairments that can last a lifetime. In the worst cases, prenatal alcohol exposure can result in miscarriage. Even when babies survive, many effects go unnoticed until school age, when children face challenges with learning, memory, and self-control.
Shifting Focus to Public Health
Shchetinina didn’t start her career in public health. She was originally a law student when she encountered that mother at the crisis center. “It was just heartbreaking,” she recalls. The experience sparked a growing interest in the effects of alcohol use during pregnancy. She learned more and more about the issue and decided to shift her focus from law to public health.
Her path took her to the U.S. under the Fulbright program, where she earned a master’s degree in public health at the University of Minnesota. Today, she is continuing her research as a doctoral student at Harvard, where she is studying the long-term effects of prenatal alcohol exposure on adult health.
The Growing Field of Fetal Alcohol Spectrum Disorder Research
Fetal alcohol spectrum disorder (FASD) includes a range of conditions caused by prenatal alcohol exposure, with the most severe form being fetal alcohol syndrome. Despite being 100 percent preventable, it remains a significant issue worldwide. According to Shchetinina, research on the long-term effects of prenatal alcohol exposure is still in its early stages.
“There are a lot of unknowns in this field,” she says. “We are still just beginning to understand what its effects are on adult health: When people with prenatal alcohol exposure mature, what happens to them?”
Her research is groundbreaking, using data from three extensive studies — two in the U.S. and one in Europe — to examine the long-term consequences of prenatal alcohol exposure. The effects of this exposure can be subtle and often go undiagnosed for years, complicating treatment and intervention.
A New Study Sheds Light on Alcohol Use Among Mothers
In April, Shchetinina published a study in the journal PLOS One, examining the prevalence of alcohol-use disorder among pregnant and parenting women. The study analyzed data from the National Survey on Drug Use and Health, which included responses from 120,000 women aged 18 to 49 between 2015 and 2021.
The findings were stark. Among women who were not pregnant and did not have children, about 13 percent met the criteria for alcohol-use disorder, yet only 4 percent were receiving treatment. The disorder was less common among pregnant and parenting women, affecting 6.3 to 6.6 percent, but a significant treatment gap remained, with just 5 percent of those women in treatment.
According to the study, one of the key barriers to treatment was financial. Women with private or through Medicaid insurance were more likely to receive treatment. However, Shchetinina believes that stigma also plays a role. Many women may not seek treatment for fear of being judged, particularly during pregnancy.
The Judicial System: A Path to Treatment?
Interestingly, the study found that women with a history of arrest were more likely to be in treatment. Shchetinina suggests this may be because the judicial system acts as a gateway to healthcare, a trend she finds troubling.
“The judicial system serving as an entry point to health care is problematic and should not be the easiest path to getting help,” she says. “Providers need to be more proactive, and society needs to be more supportive.”
Shchetinina is expected to complete her doctoral studies in 2026 and hopes to continue her research in the U.S. due to the changes in Russia following its invasion of Ukraine. The crisis center where she first volunteered has since closed, and Shchetinina’s dissent against the war has put her at risk.
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For now, she remains focused on shining a light on the long-term consequences of prenatal alcohol exposure. Her work, still in its early stages, is helping to fill in the gaps in understanding how this preventable condition affects children and adults.
“Every decision matters,” she says. And thanks to her, families affected by alcohol use during pregnancy may one day find better solutions and brighter futures. For more updates around the world, keep reading at Education Post News.
