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International adoption is an increasingly common phenomenon. With nearly 20,000 foreign-born adoptees entering United States families every year, most pediatricians can expect to encounter one or more of these children in their practices. However, as the demographics and medical risks of intercountry adoption continue to change, it also is likely that prospective adoptive parents will seek pediatric advice prior to completing their adoption. The goal of this review is to highlight the general and specific concerns that pediatric clinicians should address as they prepare families for international adoption.

In 1989, approximately 8,000 children were adopted into United States homes from foreign countries. Most came from Korea, relinquished by young mothers who were stigmatized by out-of-wedlock pregnancy (FigureF1). Most of these children received United States-style pediatric care and were nurtured in well-funded foster homes until their adoption was completed, usually...

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