UAE sees high rates of Down Syndrome

DUBAI // The pressure on Emirati mothers to have more children is probably the main reason for the high rate of Down Syndrome in the country, a Government official said. The risk of a child being born with Down Syndrome, a genetic disorder that causes lifelong damage to mental development, increases with the age of the mother. Globally, about one in 800-1,000 newborns have Down Syndrome. A study published in 2007 that looked at more than 63,000 newborn babies in Dubai between 1999 and 2003 estimated Down Syndrome incidence at one in every 449 live births, with the rate among nationals at one in 319. "This was very alarming," said Dr Eman Gaad, the director of disability services at the Community Development Authority. "Many children [with Down Syndrome] are born to young parents, but the only factor we can put our hands on is the maternal age of mothers." The same study concluded that more than 41 per cent of Emirati mothers were over 35, the age at which Down Syndrome risk increases. "At the moment girls are getting an education. By the time she graduates from university and finds her soulmate, we're talking about the late twenties, not like before," said Dr Gaad, speaking a week after she addressed a Down Syndrome symposium that tackled the rights of children with disabilities. A woman is under "tremendous pressure to have more babies" in a society that understandably wants to grow, she added. "It's okay to have a child or two or five, but once you hit 40 you have to be really careful," she said. "If it's God's will and an accident it's okay, but it's a phenomenon, that many women keep just having children. There is no awareness that it's really time to stop." She suggested that pregnancy often also has alluring connotations of fertility and youth, whereas education about the risks of high maternal age is lacking. Pressure by authorities to increase the birth rate was unlikely to work, but social influence was certainly a driving force for high maternal age, said Dr Suaad al Oraimi, assistant professor of sociology at UAE University and an expert on women's education. High maternal age was the result of "simple, traditional, tribal" culture, she said. "Simple culture considers children a form of honour, and we are a traditional society," said Dr al Oraimi. Having children is not particularly expensive for nationals, she said. The Government pays for the education and healthcare of Emirati children, and women often have maids or extended family to help in taking care of them, said Dr al Oraimi. Dr Khawla Bu Hmaid, a gynaecologist at Al Baraha Hospital in Dubai, said new research was needed to bring the figures of Down Syndrome incidence up to date. She said the phenomenon of higher maternal age was not unique to the UAE. "Of course women are now working, the age to get married and to have babies is older, especially because more people want to do higher studies," she said. She agreed, however, that women in the country as well as the rest of the Gulf region were under pressure to have up to six babies. A test can determine if a foetus is likely to have a defect, In amniocentesis, a needle takes a sample of amniotic fluid, which covers a foetus in the womb, between 14 and 20 weeks of pregnancy. According to the Harvard Medical School, the test is often recommended for women older than 35. A study published in the UK in 1999 said that 92 per cent of cases where a foetus is diagnosed with Down Syndrome end in abortions. Most Islamic scholars prohibit abortion except in extreme cases where pregnancy is life-threatening to the mother. Some scholars have argued that abortion with strong cause is permitted during the first six to eight weeks, before the foetus develops a pulse, or during the first four months before the foetus is infused with a spirit, according to Islamic tradition. However, UAE authorities prohibit abortion unless doctors certify it is life-threatening for the mother. A disability is not considered a justifiable reason for an abortion, according to the General Authority of Islamic Affairs and Endowments, as a child with a disability is simply another one of God's creations deserving of life. [e-mail]