Current trends of consanguineous marriages and its association with socio-demographic variables in Pakistan
Keywords:Congenital anomalies, Consanguinity, Consanguineous marriage, Muslim communities, Traditions
Background: A high proportion of marriages in South and Middle East Asia are contracted between close biological relatives due to cultural preference as it is a deeply rooted social fashion among these societies. The aim of this study was to determine the frequency of consanguineous marriages and ascertain their relationship to relevant sociodemographic variables.
Methods: This was a cross sectional descriptive study conducted in tertiary care hospital of Islamabad. Data were collected on a specially designed questionnaire form. Age of participants, their education, socioeconomic status, castes and number of anomalous children born to these participants, degree of consanguinity and reasons of preferences were inquired.
Results: Out of 300 women chosen by convenience sampling technique, 62% had consanguineous marriages, and 38% had a non-consanguineous union. The mean age of women presenting to maternal and child health centre was 27 years. The average age of a woman having consanguineous marriage was 21 years in contrast to 24 years for non-consanguineous nuptial. About 18% of women in consanguineous marriages were illiterate as compared to 5.4% (p = 0.001) of women in non-consanguineous unions. First cousin marriages were more common among certain castes like Rajput and Awan. None in the consanguineous group had any anomalous baby in contrast to non-consanguineous who had two anomalous children (p = 0.0001). There was no significant association between type of marriage and the number of miscarriages (p=0.69).
Conclusions: Majority women still prefer cousin unions for their progeny due to traditions and family security reasons irrespective of their education and social status. Therefore, it is important to incorporate prenatal genetic counseling sessions in community programs to raise awareness about repercussions of consanguinity on future generations.
Hamamy H. Consanguineous marriages: Preconception consultation in primary health care settings. J Community Genet. 2012; 3(3):185-92.
Bittles AH. A background summary of consanguineous marriage. Centre for Human Genetics. Edith Cowen University. 2001 Perth.
Tadmouri GO, Nair P, Obeid T, Ali MTA, Khaja NA & Hamamy HA. Consanguinity and reproductive health among Arabs. Reprod Health. 2009; 6(1):17.
Bittles AH. Consanguineous marriages and congenital anomalies. The Lancet. 2013;382(9901): 1316-7.
Small N, Bittles AH, Petherick ES, & Wright J. Endogamy, consanguinity and the health implications of changing marital choices in the UK Pakistani community. J Biosoc Sci. 2017;40(4):435-46.
Agha N. Kinship in rural Pakistan: Consanguineous marriages and their implications for women. Women's Stud. Int. Forum. 2016;54:1-10.
Jaber L. & Halpern GJ. Definition, Background, History, and Legal, Religious and Biological Aspects. Consanguinity–Its Impact, Consequences and Management. 2014;28:3-30.
Hussain R. Community perceptions of reasons for preference for consanguineous marriages in Pakistan. J Biosoc Sci.1999;31:449-61.
Shami SA, Grant JC, and Bittles AH. Consanguineous marriage within social/occupational class boundaries in Pakistan. Journal of Biosocial Science. Cambridge University Press 1994;26(1): 91-6.
Wiebracht B. First Cousin marriage in Tudor and Stuart England. J Family Hist 2015;40(1):24-38.
Kuper A. Incest, cousin marriage, and the origin of the human sciences in nineteenth-century England. Past and present. 2002;(174):158-83.
Diane BP. and Hamish GS. “It's Ok, We're Not Cousins by Blood”: The Cousin Marriage Controversy in Historical Perspective. PLOS Biology;6(12):e320.
Shaw A. Drivers of cousin marriage among Pakistani British. Human Hereditary. 2014;77:26-36
Riaz HF, Mannan S, & Malik S. Consanguinity and its socio-biological parameters in Rahim Yar Khan District, Southern Punjab, Pakistan. J Health, Popul Nut. 2016;35(1):14.
Jones GW. Changing marriage patterns in Asia. Asia Research Institute Working paper Series No 131. Asia Research Institute and Department of Sociology. Nat Uni Singapore. 2010; 3-17.
Hina S & Malik S. Patterns of consanguinity and inbreeding coefficient in Sargodha district, Punjab, Pakistan. J Biosoc Sci. Cambridge University Press; 2015;47(6):803-11.
Bittles AH, Grant JC, & Shami SA. Consanguinity as a determinant of reproductive behaviour and mortality in Pakistan. International Journal of Epidemiol. 1993;22(3):463-7
Qidwai W, Syed IA & Khan FM. Prevalence and perceptions about consanguineous marriages among patients presenting to family physicians, in 2001 at a Teaching Hospital in Karachi, Pakistan. Asia Paci Family Med. 2003;2:27-31.
Pakistan Demography and Health Survey 2012-2013. National Institute of Population studies. Islamabad. Pakistan.
Ghazi OT, Pratibha N, Tasneem O, Mahmoud TAA, Najib AK and Hanan AH. Consanguinity and reproductive health among Arabs. Reproduct Health. BMC 2009;6:17
Hussain R, Bittles AH. Assessment of association between consanguinity and fertility in Asian populations. J Health Popul Nutrit. 2004;22:1-12.
Afzal M, Ali SM, Siyal HB. Consanguineous marriages in Pakistan. Pak Rev Dev. 1994; 33(4 Pt 2): 663-74.
Hussain R, Bittles AH, Sullivan S. Consanguinity and early mortality in the Muslim populations of India and Pakistan. Am J Hum Biol. 2001;13:777- 87.
Shami SA, Qaisar R, Bittles AH. Consanguinity and adult morbidity in Pakistan. Lancet. 1991;12: 338-54.
Bittles AH. Time to get real: Investigating Potential Beneficial Genetic Aspects of Consanguinity. Public Health Genom. 2010;14:169-71.
Afrose B. and Jehan, F. Prenatal genetic counseling in a resource limited country-a single center geneticist’s perceptive. JPMA. 2014;64(9):1008-11.