Utilization of prenatal diagnosis and termination of pregnancies for the prevention of Down syndrome in Israel.
BACKGROUND
The national program for the prevention of Down syndrome includes screening (using the triple test) and invasive diagnostic tests in women at risk for a Down syndrome pregnancy. However, despite the program, the majority of Down syndrome infants are born alive (approximately 1/1000 live births).


OBJECTIVE
To determine whether the relatively high incidence of Down syndrome at birth in Israel is the result of failure of the preventive program or due to informed choices of the mothers.


METHODS
We conducted a retrospective study using the national registry of Down syndrome for the years 1997 and 2004, according to the mothers' religion and place of residence and the reasons for prenatal diagnosis.


RESULTS
Most of the babies affected with Down syndrome are born in religious or traditional conservative communities where termination of pregnancy is usually not an option.


CONCLUSIONS
In a pluralistic society like Israel with its diverse communities and dissimilar religious backgrounds and traditions, the different attitudes concerning utilization of the national program should be respected. It is necessary to tailor different approaches and solutions for the various ethnic and religious communities according to their need.
Zlotogora
Joël
J
Public Health Services and Department of Health Information, Ministry of Health, Tel Hashomer, Israel. joelz@cc.huji.ac.il
Haklai
Ziona
Z
Leventhal
Alex
A
D000028:Abortion, Induced / Q000706:statistics & numerical data*; D000328:Adult; D002755:Choice Behavior; D004314:Down Syndrome / Q000208:ethnology / Q000517:prevention & control*; D005260:Female; D006801:Humans; D007514:Islam; D007557:Israel / Q000453:epidemiology; D007585:Jews; D011247:Pregnancy; D011296:Prenatal Diagnosis; D012189:Retrospective Studies