71.  Husseini. A, Akkawi. M.  Maternal serum screening of Palestinian women in the West Bank.  Eastern Mediterranean Health Journal. 2005; 11(4): 5 pages.

The study presents the results of the serum screening triple test done between the 14^th and 20^th week of a pregnancy.  The analyzed indicators are Alpha-fetoprotein (AFP), unconjugated estriol (uE3), and human chorionic ganodotropin (hCG).  Elevated level of AFP indicates an increased risk of neural tube defect and reduced level indicate increased level of Down syndrome.  Abnormal level of hCG and uE3 indicate chromosomal defects.  These indicators are used to detect the presence of genetic defects and disorders in the fetus.  Records of 943 Palestinian women were reviewed.  The mean expected age at delivery was 25.5 ± 0.2 years; pregnancy at an older age increases the risk of Down syndrome.  Results indicated a frequency of 1.3% for elevated AFP, 1.6% for elevated hCG, and 0.3% for reduced hCG and uE3 respectively.  The risk for Down syndrome was the lowest in the 15-24 yrs age group (1.2%), and 16.2% for the age group > 35 yrs old.  The total calculated risk was 2.8%. Conclusion: The low total calculated risk for Down syndrome for Palestinian women is attributed to the sample young age at pregnancy.  Older women (> 35 yrs) have 13-fold increased risk of having a Down syndrome baby compared to the 15-24 yrs age group.  In addition, there is a lower risk for neural tube defects (1.3% risk) among Palestinian women in the sample compared to the usual outcome of 3% risk for Down syndrome.