Ministry of Health Denies Report of Births of 12 Babies with Down Syndrome

The Iranian Ministry of Health has denied the report of the birth of 12 children with Down syndrome in the past year from a single laboratory center, which was published by Shargh newspaper citing the head of a specialized fetal health laboratory. Pedram Pak-Aein, the spokesperson for the Ministry of Health, stated that encouraging pregnant mothers to undergo screening is not for health reasons but for 'increasing the profits of screening stakeholders' who, according to him, distort realities and earn 'over a thousand billion tomans' annually. This health official claimed that based on statistics from the Ministry of Health's electronic systems, there has been no increase in the birth of babies with abnormalities since the implementation of the 'Family Support and Population Youth' law. Pak-Aein added that the previous mandatory screening method was costly and risky and, according to him, lacked 'scientific standards,' but after the new law was implemented, it became 'accurate and scientific.' Nearly two years have passed since the approval of the so-called 'Family Support and Population Youth' plan, and the head of the Women and Family Fraction of the Islamic Consultative Assembly stated in May this year that only 30% of this law has been implemented. The provisions of this law set conditions for screening, including Article 53, which states that all issued guidelines related to pregnancy and maternal and fetal health that 'recommend or lead doctors and health-care workers or mothers to abortion' must be eliminated, but exceptions are made for cases where the mother's life is at risk or complications arise for the mother or fetus. However, a few months later, the Ministry of Health issued directives to eliminate 'fetal abnormality' screening from electronic systems under the pretext of implementing Article 53. According to this directive, insurers were prohibited from covering the costs of stages and tests for detecting fetal defects. Many experts protested this decision, stating that the elimination of fetal abnormality screening would increase the risk of giving birth to disabled infants and that screening tests would become an underground and luxury service for wealthy families. Recently, the Ministry of Health informed 86 scientific associations that screening 'serves the interests of certain individuals' and that screening 'even for cancer' should also be limited. On the other hand, the news of the suspension of issuing permits for the production and import of first-trimester screening kits by the Ministry of Health surprised and drew criticism from specialists. The head of the Iranian Medical Genetics Association told Khabar Online that in the new medical equipment guidelines from the Ministry of Health, it was initially stated that any production and import of screening kits was prohibited, but later the 'title of the directive' was changed. While 'the content remains the same,' he insists on 'the prohibition.' Health officials of the Islamic Republic state that only the import of 'cheap' kits with a high error rate is banned, and laboratories must obtain approval from the Ministry of Health to conduct screenings. Statistics on the error rates of screening tests in Iran, reportedly obtained through field studies, indicate an error rate between 12.5% to 16%. Screening tests are methods or tests conducted to determine whether a woman or her newborn may have specific problems. Non-invasive prenatal tests, which analyze the blood of the pregnant individual to find more common chromosomal abnormalities, can usually accurately and with a low error rate determine whether the newborn is at risk for Trisomy 21 (Down syndrome), Trisomy 18 (Edwards syndrome), and Trisomy 13 (Patau syndrome). Sometimes, several rare disorders can also be screened in the first ten weeks of pregnancy. If the results of these types of screening tests are abnormal, doctors usually suggest further diagnostic tests to determine the presence of potential problems in the newborn. Many genetic abnormalities can be detected using prenatal screening methods.