Perinatal depressive symptoms among Arab women in northern Israel.

Perinatal depression, a prevalent condition with negative consequences for the mother, infant and family, has been reported in many countries. This study aimed to assess the scope of depressive symptoms among pregnant and postnatal Israeli Arab women and to identify possible risk factors. Data were collected from a screening program at 58 Mother-Child Health Care clinics in northern Israel from June to December, 2009. Participants included 1,254 pregnant and 2,326 postnatal women. The rate of antenatal depressive symptoms, i.e., a score of ≥10 on the Edinburgh Postnatal Depression Scale (EPDS) was 20.8%. Women attending clinics with primarily religious or traditional populations had lower rates antenatally than did those described as secular. During the postnatal period 16.3% of the women scored ≥10 on the EPDS. The rate of postnatal depressive symptoms was significantly higher among women living in Moslem than Druze communities (EPDS ≥ 10: 19.0% vs. 13.4%, respectively, P = 0.01). Postnatally, there were no significant differences according to SES cluster, community size, or religious orientation. The rate of antenatal and postnatal depression among Arab women in northern Israel was somewhat higher than that of Jewish Israeli women in the same region, and considerably lower than that of Arab Bedouin women in southern Israel. Given the differences in their life styles and circumstances, health policy authorities should be informed regarding the needs of these various sub-populations.

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

PURPOSE: The Druze community is characterized by consanguinity and endogamy, and by reluctance to genetic testing and technological interventions for the prevention of birth defects. Multiple patients with four rare and severe inborn errors of metabolism cerebrotendinous xanthomatosis, prolidase deficiency, argininosuccinate lyase deficiency, and carbamyl phosphate synthetase I deficiency were identified in an isolated Druze village in northern Israel. The aims of this study were to identify couples at risk for four inherited diseases, and to prevent birth defects in a community presenting religious and cultural obstacles to genetic testing. METHODS: A genetic screening and counseling program in a high-risk community. RESULTS: The 1425 residents who attended group genetic counseling sessions between 2003 and 2007 consented to genetic testing. We identified 217 carriers for either one or two disease causing mutations. High carrier frequencies for cerebrotendinous xanthomatosis, prolidase deficiency, argininosuccinate lyase deficiency, and carbamyl phosphate synthetase I deficiency were identified as 1:11, 1:21, 1:41, and 1:95, respectively. Fifty-eight percent (125) of the carriers' spouses agreed to genetic counseling and testing. Ten couples at risk for affected offspring were identified and offered prenatal genetic counseling and diagnosis. CONCLUSIONS: The genetic screening program, the first of its kind reported in a Druze community, was well received. We expect this program to increase awareness of genetic counseling, to contribute to disease prevention, and to serve as a model for other isolated communities.