DUBAI // The pressure on Emirati mothers to have more children is probably the main reason for the "alarming" rate of Down's syndrome in the country, an official has said.
The risk of a child being born with Down's syndrome, a genetic disorder that causes lifelong damage to mental development, increases with the age of the mother.
Globally, about one in 800 to 1,000 new-born babies have Down's syndrome. A study published in 2007 that looked at more than 63,000 new-born babies in Dubai between 1999 and 2003 estimated an incidence of Down's syndrome in 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's syndrome] are born to young parents, but the only factor we can put our hands on is the maternal age of mothers."
The study concluded that more than 41 per cent of Emirati mothers were over 35, the age at which the risk of Down's syndrome 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 20s, not like before," said Dr Gaad, speaking a week after she addressed a Down's syndrome symposium that tackled the rights of children with disabilities.
A woman was under "tremendous pressure to have more babies" in a society that, understandably, wanted to grow, she added.
"It's OK to have a child or two, or five, but once you hit 40 you have to be really careful," Dr Gaad said. "If it's God's will and an accident it's OK, but it's a phenomenon that many women keep having children. There is no awareness that it's really time to stop."
Dr Gaad suggested that pregnancy often carried alluring connotations of fertility and youth, whereas education about the risks of high maternal age was lacking.
Pressure from the 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 cultures consider children a form of honour, and we are a traditional society," Dr al Oraimi said.
Having children was not particularly expensive for nationals, she said. The Government paid for the education and health care of Emirati children, and women often had maids or extended family to help in looking after them, said Dr al Oraimi.
Dr Khawla Bu Hmaid, a gynaecologist at Al Baraha Hospital in Dubai, said new research was needed to bring Down's syndrome figures up to date. Higher maternal age was not unique to the UAE, she said.
"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," Dr Bu Hmaid said.
She agreed, however, that women in the 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 over 35. A study published in Britain in 1999 said 92 per cent of cases in which a foetus is diagnosed with Down's syndrome ends in an abortion.
Most Islamic scholars prohibit abortion except in extreme cases where pregnancy threatens the life of 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, in the UAE abortion is prohibited 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.
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The rules on fostering in the UAE
A foster couple or family must:
- be Muslim, Emirati and be residing in the UAE
- not be younger than 25 years old
- not have been convicted of offences or crimes involving moral turpitude
- be free of infectious diseases or psychological and mental disorders
- have the ability to support its members and the foster child financially
- undertake to treat and raise the child in a proper manner and take care of his or her health and well-being
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Mercer, the investment consulting arm of US services company Marsh & McLennan, expects its wealth division to at least double its assets under management (AUM) in the Middle East as wealth in the region continues to grow despite economic headwinds, a company official said.
Mercer Wealth, which globally has $160 billion in AUM, plans to boost its AUM in the region to $2-$3bn in the next 2-3 years from the present $1bn, said Yasir AbuShaban, a Dubai-based principal with Mercer Wealth.
“Within the next two to three years, we are looking at reaching $2 to $3 billion as a conservative estimate and we do see an opportunity to do so,” said Mr AbuShaban.
Mercer does not directly make investments, but allocates clients’ money they have discretion to, to professional asset managers. They also provide advice to clients.
“We have buying power. We can negotiate on their (client’s) behalf with asset managers to provide them lower fees than they otherwise would have to get on their own,” he added.
Mercer Wealth’s clients include sovereign wealth funds, family offices, and insurance companies among others.
From its office in Dubai, Mercer also looks after Africa, India and Turkey, where they also see opportunity for growth.
Wealth creation in Middle East and Africa (MEA) grew 8.5 per cent to $8.1 trillion last year from $7.5tn in 2015, higher than last year’s global average of 6 per cent and the second-highest growth in a region after Asia-Pacific which grew 9.9 per cent, according to consultancy Boston Consulting Group (BCG). In the region, where wealth grew just 1.9 per cent in 2015 compared with 2014, a pickup in oil prices has helped in wealth generation.
BCG is forecasting MEA wealth will rise to $12tn by 2021, growing at an annual average of 8 per cent.
Drivers of wealth generation in the region will be split evenly between new wealth creation and growth of performance of existing assets, according to BCG.
Another general trend in the region is clients’ looking for a comprehensive approach to investing, according to Mr AbuShaban.
“Institutional investors or some of the families are seeing a slowdown in the available capital they have to invest and in that sense they are looking at optimizing the way they manage their portfolios and making sure they are not investing haphazardly and different parts of their investment are working together,” said Mr AbuShaban.
Some clients also have a higher appetite for risk, given the low interest-rate environment that does not provide enough yield for some institutional investors. These clients are keen to invest in illiquid assets, such as private equity and infrastructure.
“What we have seen is a desire for higher returns in what has been a low-return environment specifically in various fixed income or bonds,” he said.
“In this environment, we have seen a de facto increase in the risk that clients are taking in things like illiquid investments, private equity investments, infrastructure and private debt, those kind of investments were higher illiquidity results in incrementally higher returns.”
The Abu Dhabi Investment Authority, one of the largest sovereign wealth funds, said in its 2016 report that has gradually increased its exposure in direct private equity and private credit transactions, mainly in Asian markets and especially in China and India. The authority’s private equity department focused on structured equities owing to “their defensive characteristics.”
