Intercountry adoptees in out-of-home care: a national cohort study

AIM: To investigate risks of placements in out-of-home care for non-European adoptees. METHODS: Intercountry adoptees born outside Europe 1973-1984 (n = 16,522) were compared with same age peers from the majority population (n = 1,026,523) using national demographic and child welfare registers. Multivariate analyses were performed using logistic regression models, and odds ratios (OR) for different forms of out-of-home care placements were calculated. RESULTS: After adjustments for socio-demographic background variables, the OR:s for placements of intercountry adoptees in residential care from age 10 were 5.1 (95% CI 4.6-5.8) and 3.0 (95% CI 2.6-3.6) for placements in foster care from age 10. For placements in all forms of out-of home care up to age 10, the odds were on par with the majority population. Higher child age at adoption, origin from Latin America, single parent adoption and maternal age above 35 at birth of the child were identified as significant predictors of out-of-home care from age 10. CONCLUSION: Intercountry adoptees emerge as a risk group for placements in out-of home care during adolescence, especially for entries into residential care (in Sweden usually triggered by persistent behaviour problems).