Israeli Health Ministry Report: Down Syndrome Diagnosis Lower in Arab Community

Prenatal tests to reveal the existence of Down syndrome, like nuchal scan or obstetric ultrasonography, not included in health care package and not subsidized by the government.

The rates of prenatal diagnosis of Down syndrome among Arabs fall far short of those among Jews, a Health Ministry report revealed on Thursday.

The figures show that among births of babies with Down syndrome, 52 percent of Arab expectant parents did not take additional testing after an initial doubt was raised during the pregnancy, as opposed to 35 percent of Jewish parents. Also, there were no preliminary symptoms during the pregnancy in 26 percent of Down syndrome births among Arabs, as opposed to a mere 8 percent among Jews.

Prenatal tests to reveal the existence of Down syndrome, like nuchal scan or obstetric ultrasonography, are not included in the health care package and are therefore not subsidized by the government.

"Only a blood test also known as 'the triple test' is currently subsidized by the government," says Prof. Joel Zlotogora, the head of the Health Ministry's department of community genetics, who presented the findings in a conference at Jerusalem's Hadassah University Hospital on Thursday. "Arab parents tend not to go beyond this test, whose accuracy rate stands at just 70 percent."

Down syndrome often causes heart defects and entails a higher risk of infections, as well as early childhood death in some cases. However, the methods of treatment have significantly improved and 85 percent of children with Down syndrome live past the age of five nowadays, as opposed to just 55 percent 20 years ago.

The data also reveals a significant gap between parents' propensity to take prenatal tests, whose results may warrant an abortion, in different communities in Israel.

While the rates of Down syndrome births are similar among Jews and among Arabs (0.96 and 1.06 per thousand births, respectively ), they are significantly higher in communities with a high number of ultra-Orthodox residents. In the predominantly ultra-Orthodox city of Bnei Brak, the rate stands at 1.8 per thousand births, and is slightly lower in Jerusalem and Beit Shemesh, two cities with a large contingent of Haredi residents (1.6 and 1.2, respectively ).

In predominantly secular cities, the rates stand at 0.8 Down syndrome cases per thousand births in Netanya, 0.6 in Petah Tikva, 0.5 in Rishon Letzion and 0.3 in Holon.

In Haredi cities, the number of expectant mothers over the age of 35 who chose to take the amniotic fluid test - which can diagnose Down syndrome at an accuracy of more than 90 percent - was significantly lower than in predominantly secular cities.

Several blood tests are in the process of being developed as an alternative to the invasive amniotic fluid test, which is relatively risky for both the mother and the fetus. Some of those, which are yet to become operational, were presented at Thursday's conference. "It is too soon to administer these blood tests comprehensively," said Prof. Zlotogora, "but those days are fast approaching. Our goal is to reduce Down syndrome babies only to cases in which the parents made an informed decision not to do prenatal testing."