Maternal Knowledge of Prenatal Screening and Down Syndrome among Pregnant Women in Eastern Libya: A Multicentre Cross-Sectional Study University

• Taweda Abdelraouf Akrim

  Faculty of Pharmacy, University of Tobruk, Tobruk, Libya

  Author

  https://orcid.org/0009-0003-3698-3117

Prenatal screening for Down syndrome is an essential component of antenatal care because it supports informed decision-making and early identification of fetal chromosomal abnormalities. However, evidence regarding pregnant women's knowledge of prenatal screening remains limited in Libya. This study assessed maternal knowledge of prenatal screening and Down syndrome and examined the demographic and obstetric factors associated with maternal knowledge among pregnant women attending antenatal care services in eastern Libya. A quantitative multicentre cross-sectional study was conducted among 2,000 pregnant women recruited from antenatal clinics in Benghazi, Derna, Al-Marj and Al-Bayda using purposive sampling. Data were collected using a structured self-administered electronic questionnaire assessing socio-demographic characteristics, obstetric history, and knowledge of prenatal screening and Down syndrome. Data were analysed using IBM SPSS Statistics version 28. Descriptive statistics, reliability and validity assessment, normality testing, Pearson's correlation, simple linear regression, and multiple linear regression analyses were performed. Most participants were aged 25–29 years (35.5%), had university education (41.5%), were multiparous (58.5%), and had previously received counselling regarding prenatal screening (61.5%). The overall knowledge score indicated a moderate level of knowledge (mean = 3.56 ± 0.59). The highest knowledge scores related to the importance of counselling before screening (4.26 ± 0.68) and healthcare professionals explaining screening results (4.18 ± 0.71), whereas knowledge of non-invasive prenatal testing and the distinction between screening and diagnostic testing was comparatively lower. Maternal educational level (r = 0.48, β = 0.44), maternal age (r = 0.31, β = 0.28), gestational age (r = 0.22, β = 0.20), and previous obstetric experience (r = 0.36, β = 0.33) were all significant positive predictors of maternal knowledge (all p < 0.001). The adjusted regression model explained 38.7% of the variance in maternal knowledge. These findings highlight the need to strengthen antenatal education and structured counselling to improve informed decision-making regarding prenatal screening in Libya.

Abdulmalek, L. J. (2017). Knowledge, attitude and practice regarding folic acid among pregnant women in Benghazi, Libya. Ibnosina Journal of Medicine and Biomedical Sciences, 9(3), 67–71. https://doi.org/10.4103/1947-489X.210113

Adeyokunnu, A. A. (1982). The incidence of Down’s syndrome in Nigeria. Journal of Medical Genetics, 19(4), 277–279. https://doi.org/10.1136/jmg.19.4.277

Alshami, H. A., Hussein, M. S. E., AlShafei, G., Rizk, H., Elmsmary, A. A., Al Shareef, D., Samer, H., Ibrahim, N., & Khaled, W. (2026). Knowledge, attitude, and perception of family members regarding the effects of anaesthesia on Down syndrome patients in Benghazi. Libyan Journal of Medical and Applied Sciences, 4(1), 93–106. https://doi.org/10.64943/ljmas.2026.04193

Arab, K., & Halawani, L. (2024). Awareness of Down syndrome screening among educated Muslim women is associated with a favorable attitude toward testing. BMC Women’s Health, 24, Article 508. https://doi.org/10.1186/s12905-024-03346-y

Chinene, B., & Mudadi, L. S. (2023). Pregnant women’s knowledge and expectations about prenatal ultrasound: A cross-sectional study. Rwanda Journal of Medicine and Health Sciences, 6(3), 346–354. https://doi.org/10.4314/rjmhs.v6i3.8

de Graaf, G., Buckley, F., & Skotko, B. G. (2017). Estimation of the number of people with Down syndrome in the United States. Genetics in Medicine, 19(4), 439–447. https://doi.org/10.1038/gim.2016.127

de Graaf, G., Buckley, F., & Skotko, B. G. (2021). Estimation of the number of people with Down syndrome in Europe. European Journal of Human Genetics, 29(3), 402–410. https://doi.org/10.1038/s41431-020-00748-y

Farshbaf Khalili, A., Shahnazi, M., Hajizadeh, K., & Shekari Khaniani, M. (2012). Down syndrome screening methods in Iranian pregnant women. Journal of Caring Sciences, 1(3), 145–151. https://doi.org/10.5681/jcs.2012.021

Fortea, J., McGlinchey, E., Espinosa, J. M., & Rafii, M. S. (2024). Addressing challenges in health care and research for people with Down syndrome. The Lancet, 403(10439), 1830–1833. https://doi.org/10.1016/S0140-6736(24)00478-1

Hafez, M., El-Tahan, M., Zedan, M., & Eisa, M. (1984). Demographic trends of Down’s syndrome in Egypt. Human Biology, 56(4), 703–712.

Jahan, A. M., & Anaiba, S. M. (2023). Exploring antenatal exercise: Knowledge, attitudes, practices, and influencing factors among pregnant women in Libya. Advances in Rehabilitation Science and Practice, 12, 27536351231212132. https://doi.org/10.1177/27536351231212132

Lakens, D. (2022). Sample size justification. Collabra: Psychology, 8(1), Article 33267. https://doi.org/10.1525/collabra.33267

McGlinchey, E., Tewolde, S., He, A., Fortea, J., Mbakile-Mahlanza, L., Tefera, A., Epenge, E., Hassenstab, J., Jäck, A., Ranchod, K., El-Jaafary, S., Levin, J., Salama, M., Rubenstein, E., Akinyemi, R., Akinyemi, T., Farombi, T., Lawlor, B., Ikanga, J., . . . Merali, Z. (2025). Down syndrome in Africa: Challenges, opportunities, and future directions. Alzheimer’s & Dementia, 21(6), Article e70388. https://doi.org/10.1002/alz.70388

Molteno, C., Smart, R., Viljoen, D., Sayed, R., & Roux, A. (1997). Twenty-year birth prevalence of Down syndrome in Cape Town, South Africa. Paediatric and Perinatal Epidemiology, 11(4), 428–435. https://doi.org/10.1046/j.1365-3016.1997.d01-25.x

Pruksanusak, N., Suwanrath, C., Kor-anantakul, O., Prasartwanakit, V., Leetanaporn, R., Suntharasaj, T., & Hanprasertpong, T. (2009). A survey of the knowledge and attitudes of pregnant Thai women towards Down syndrome screening. Journal of Obstetrics and Gynaecology Research, 35(5), 876–881. https://doi.org/10.1111/j.1447-0756.2009.01035.x

Rabbani, S. A., Mossa, M. S., Al Nuaimi, G. A., & Al Khateri, F. A. (2023). Down syndrome: Knowledge and attitudes among future healthcare providers. Journal of Taibah University Medical Sciences, 18(5), 1179–1187. https://doi.org/10.1016/j.jtumed.2023.03.013

Rabiee, M., Jouhari, Z., & Pirasteh, A. (2019). Knowledge of prenatal screening, Down syndrome, amniocentesis, and related factors among Iranian pregnant women: A cross-sectional study. International Journal of Community Based Nursing and Midwifery, 7(2), 150–160. https://doi.org/10.30476/IJCBNM.2019.44886

Setia, M. S. (2016). Methodology series module 3: Cross-sectional studies. Indian Journal of Dermatology, 61(3), 261–264. https://doi.org/10.4103/0019-5154.182410

Smith, S. K., Cai, A., Wong, M., Sousa, M. S., Peate, M., Welsh, A., Meiser, B., Kaur, R., Halliday, J., Lewis, S., Trevena, L., Yanes, T., Barlow-Stewart, K., & Barclay, M. (2018). Improving women’s knowledge about prenatal screening in the era of non-invasive prenatal testing for Down syndrome: Development and acceptability of a low literacy decision aid. BMC Pregnancy and Childbirth, 18, Article 499. https://doi.org/10.1186/s12884-018-2135-0

Wang, X., & Cheng, Z. (2020). Cross-sectional studies: Strengths, weaknesses, and recommendations. Chest, 158(1S), S65–S71. https://doi.org/10.1016/j.chest.2020.03.012

Zhao, Y., Xue, Z., Geng, Y., Zhu, J., Hu, M., & Jiang, M. (2023). Understanding knowledge, perception, and willingness of non-invasive prenatal testing for fetal aneuploidy: A survey among Chinese high-risk pregnant women. Frontiers in Medicine, 10, Article 1232942. https://doi.org/10.3389/fmed.2023.1232942

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