Abstract
Background and Aims:
Down syndrome is the most common chromosomal abnormality occurring in live born infants. In Saudi Arabia termination of pregnancy is considered illegal and both religiously and culturally unacceptable. Our aim was to explore views, attitudes, and knowledge about Down syndrome, prenatal screening, integrating Down syndrome individuals in the community, willingness to terminate preg¬nancy.

Methods:
This cross-sectional study was conducted using a pre-validated questionnaire and carried out through face-to-face interviews, in Hail, Saudi Arabia from July-August 2019.

Results:
A total of 337 married women participated in this study, about Half were college graduates 157337(46.6%). Participants expressed opposition as “extremely opposed” to Down syndrome individuals to be involved in the community in schools, have jobs and attend public places 108337 (32.0%), 140337(41.5%) and 139337(41.2%) respectively. Illiterate participants were more willing to continue a pregnancy with Down syndrome fetus (AOR 9.7,95%CI: 2.2 – 42.8, p=0.003). In comparison, participants with college education were more willing to terminate (OR 1.6 95% CI: 1.0- 2.4, P=0.038). Moreover, awareness about prenatal tests were of no significant association with the willingness to terminate.

Conclusions:
This study has shown lack of knowledge about Down syndrome and most Saudi women in Hail are willing to undergo NIPT to prepare mentally for the child, but not go as far as TOP. This study also highlights the opinions of women towards the integration of DS individuals in the community. Further research on these questions would be useful to explore the reasons for the stigma surrounding the inclusion of DS individuals.

Key words: Down Syndrome, Trisomy 21, DS Fetus, Complicated Pregnancy, DS Child, Willingness to Terminate, Termination of Pregnancy