Utilization of prenatal genetic testing by Israeli Moslem women: a national survey

Abstract

The number of prenatal genetic tests that are being offered to women is constantly increasing. However, there is little national data as to who is performing the tests and the reasons for doing or not doing so. The aim of the study was to evaluate the proportion of Israeli Moslem women who perform the various prenatal genetic tests and the factors affecting the performance of these tests. A 2-day survey was conducted in all the maternity departments in Israel based on a structured interview. Of the 242 women interviewed, 74.2% underwent the triple test (TT), 15.8% of the women older than 35 years who were eligible to take the test free of charge underwent amniocentesis and only 1.5% underwent fragile-X (FX) carrier testing which costs 100 dollars privately. In the stepwise regression analysis, having fewer children and having had a higher education affected the performance of the TT. None of the sociodemographic factors were associated with the performance of amniocentesis or FX carrier testing, but the sample sizes were small. The main reason reported by the women for not performing the TT and FX carrier testing was not being referred for testing. The main reason for not performing amniocentesis was that they chose not to perform the test (the majority of these women were religious or ultrareligious). Consideration should be given to providing first-trimester prenatal diagnosis when termination of pregnancy in the Moslem population is more acceptable. In addition, consideration should be given to including state-subsidized FX testing as there is a low rate of FX testing partly due to the cost. Primary care givers should be educated about the importance of prenatal genetic testing.

Increasing Rates of Prenatal Testing among Jewish and Arab Women in Israel over One Decade

“…The rate of amniocentesis among the Jewish women ≥35 years was 47.5% in 2010 and 47.6% in 2001. There was a nonsignificant drop in the number of amniocenteses observed for the secular women in this age group (82.8% in 2001; 71.4% in 2010, p = 0.3) [2]. This might be related to the introduction of nuchal translucency and new serum biochemical marker screenings and to the fact that amniocentesis is no longer recommended solely on the basis of a woman's age.…”

“…In 2001, the Israeli Center for Disease Control conducted a national survey to evaluate the uptake of prenatal tests among pregnant Jewish and Arab women in Israel [1,2]. The results of that survey revealed significant differences between the 2 population groups.…”

“…The results of that survey revealed significant differences between the 2 population groups. The rates for amniocentesis, nuchal translucency screening, late ultrasound level 2, and carrier screening for fragile X and cystic fibrosis were significantly lower among the Arab than among the Jewish women [1,2]. …”

Population screening in a Druze community: the challenge and the reward

“…Suspicion regarding birth defect prevention has been reported in other religious communities in Israel. 30,31 Considering the challenges inherent in a screening program in a Druze community, characterized by a secretive religion and endogamous culture, our program has made a number of achievements:…”

“…Supporting this data are a study that shows that both the severity of the disorder and the gestation time at detection of the abnormality affect an Arab couple's decision to terminate pregnancy. 30,31 The couples detected as carriers in our screening program reached clinics at a relatively late stage of their pregnancy and, therefore, were offered amniocentesis only and not CVS. Furthermore, the facts that CTX is a treatable disease, and PD is characterized by great, unpredicted phenotypic variability, complicated the genetic counseling and the decision-making process related to pregnancy management.…”