Consanguineous marriages have been practiced for hundreds of years in many parts of the world. The rate of congenital malformations among the offspring is 2.5 times higher than that among the offspring of unrelated parents, mainly due to the expression of autosomal-recessive disorders, and hospitalization for these reasons causes a major financial burden. An increase in sterility and in the rates of abortion, stillbirths, perinatal losses and neonatal deaths has been reported by some authors but not by others. It is generally accepted that the advantages of consanguinity outweigh the disadvantages; however, strategies for reducing the burden require a unique approach as discussed in this article.

Keywords:
Consanguineous marriages, Congenital malformations, Reproductivity
1.
Schull WJ, Nagano H, Yamamoto M, Komatsu I: The effects of parental consanguinity and inbreeding in Hirado, Japan. I. Stillbirths and prereproductive mortality. Am J Hum Genet 1970;22:239–262.
2.
Bittles AH, Mason WM, Greene J, Rao NA: Reproductive behavior and health in consanguineous marriages. Science 1991;252:789–794.
3.
Editorial: Lancet 1991;338:85–86.
4.
Jaber L, Shohat M, Halpern GJ: Demographic characteristics of the Israeli Arab community in connection with consanguinity. Isr J Med Sci 1996;32:1286–1289.
5.
Freire-Maia N: Effects of consanguineous marriages on morbidity and precocious mortality: Genetic counseling. Am J Med Genet 1984;18:401–406.
6.
Imaizumi Y: A recent survey of consanguineous marriages in Japan. Clin Genet 1986;30:230–233.
7.
Khoury MJ, Cohen BH, Diamond EL, Chase GA, McCusick VA: Inbreeding and prereproductive mortality in the Old Order Amish. I. Genealogic epidemiology of inbreeding. Am J Epidemiol 1987;125:453–461.
8.
Bonne B: The Samaritans: A demographic study. Hum Biol 1963;35:61–89.
9.
Shami SA, Schmitt LH, Bittles AH: Consanguinity related prenatal and postnatal mortality of the populations of seven Pakistani Punjab cities. J Med Genet 1989;26:267–271.
10.
Devi ARR, Rao NA, Bittles AH: Inbreeding and the incidence of childhood genetic disorders in Karnataka, South India. J Med Genet 1987;24:362–365.
11.
Freire-Maia N: Genetic effects in Brazilian populations due to consanguineous marriages. Am J Med Genet 1989;35:115–117.
12.
Khlat M, Khoury M: Inbreeding and diseases: Demographic, genetic and epidemiologic perspectives. Epidemiol Rev 1991;13:28–41.
13.
Thomas JD, Doucette MM, Thomas DC, Stoeckle JD: Disease, lifestyle, and consanguinity in 58 American Gypsies. Lancet 1987;ii:377–379.
14.
Khuri FI: Parallel cousin marriage reconsidered: A Middle Eastern practice that nullifies the effects of marriage on the intensity of family relationships. Man 1976;5:597–618.
15.
Kulkarni ML, Kurian M: Consanguinity and its effect on fetal growth and development: A south Indian study. J Med Genet 1990;27:348–352.
16.
Panter-Brick C: Parental responses to consanguinity and genetic disease in Saudi Arabia. Soc Sci Med 1991;33:1295–1302.
17.
Khlat M, Halabi S, Khudr A, Der Kaloustian VM: Perception of consanguineous marriages and their genetic effects among a sample of couples from Beirut. Am J Med Genet 1986;25:299–306.
18.
de Costa C: Congenital abnormalities and consanguinity (letter). Med J Aust 1986;144:721–722.
19.
Chakraborty R, Chakravarti A: On consanguineous marriages and the genetic load. Hum Genet 1977;36:47–54.
20.
Magnus P, Berg K, Bjerkedal T: Association of parental consanguinity with decreased birth weight and increased rate of early death and congenital malformations. Clin Genet 1985;28:335–342.
21.
Hamamy HA, Al-Hakkak ZS: Consanguinity and reproductive health in Iraq. Hum Hered 1989;39:271–275.
22.
El-Shafei A, Rao PSS, Sandhu AK: Congenital malformations and consanguinity. Aust NZ J Obstet Gynaecol 1986;26:168–172.
23.
Jaber L, Merlob P, Shohat M: High incidence of central nervous system malformations associated with marked parental consanguinity in an Israeli Arab community. Biomed Pharmacother 1994;48:351–354.
24.
Jaber L, Merlob P, Bu X, Rotter JI, Shohat M: Marked parental consanguinity as a cause for increased major malformations in an Israeli Arab community. Am J Med Genet 1992;44:1–6.
25.
Jaber L, Merlob P, Gabriel R, Shohat M: Effects of consanguineous marriage on reproductive outcome in an Israeli Arab community in Israel. J Med Genet 1997;34:1000–1003.
26.
Honeyman MM, Bahl L, Marshall T, Wharton BA: Consanguinity and fetal growth in Pakistani Moslems. Arch Dis Child 1987;62:231–235.
27.
Jaber L, Shohat T, Rotter JI, Shohat M: Consanguinity and common adult diseases in Israeli Arab communities. Am J Med Genet 1997;70:346–348.
28.
Shami SA, Qaisar R, Bittles AH: Consanguinity and adult morbidity in Pakistan (letter). Lancet 1991;338:954–955.
29.
Roberts DF: Consanguinity and multiple sclerosis in Orkney. Genet Epidemiol 1991;8:147–151.
30.
Afzal M: Consequences of consanguinity on cognitive behavior. Behav Genet 1988;18:583–594.
31.
Bashi J: Effects of inbreeding on cognitive performance. Nature 1977;266:440–442.
32.
Morton NE: Effect of inbreeding on IQ and mental retardation. Proc Natl Acad Sci 1978;75:3906–3908.
33.
Basaran N, Hassa H, Basaran A, Artan S, Stevenson JD, Sayli BS: The effect of consanguinity on the reproductive wastage in the Turkish population. Clin Genet 1989;36:168–173.
34.
Bittles AH, Grant JC, Shami SA: Consanguinity as a determinant of reproductive behaviour and mortality in Pakistan. Int J Epidemiol 1993;22:463–467.
35.
Al-Awadi SA, Naguib KK, Moussa MA, Farag TI, Teebi AS, El-Khalifa MY: The effect of consanguineous marriages on reproductive wastage. Clin Genet 1986;29:384–388.
36.
Rao PSS, Inbaraj SG: Inbreeding effects on human reproduction in Tamil Nadu of south India. Ann Hum Genet 1977;41:87–98.
37.
Rao PSS, Inbaraj SG: Trends in human reproductive wastage in relation to long-term practice of inbreeding. Ann Hum Genet 1979;42:401–413.
38.
Rao PSS, Inbaraj SG: Inbreeding effects on fertility and sterility in southern India. J Med Genet 1979;16:24–31.
39.
John TJ, Jayabal P: Foetal and child loss in relation to consanguinity in southern India. Indian J Med Res 1971;50:1050–1053.
40.
MacCluer JW: Inbreeding and human fetal death; in Porter I, Hook I (eds): Human embryonic and fetal death. New York, Academic Press, 1980, pp 241–261.
41.
Khoury MJ, Cohen BH, Chase GA: An epidemiologic approach to the evaluation of the effect of inbreeding on prereproductive mortality. Am J Epidemiol 1987;125:251–262.
42.
Lindelius R: Effects of parental consanguinity on mortality and reproductive function. Hum Hered 1980;30:185–191.
43.
Philippe P: Amenorrhea, intrauterine mortality and parental consanguinity in an isolated French Canadian population. Hum Biol 1974;46:405–424.
44.
Hann KL: Inbreeding and fertility in a south Indian population. Ann Hum Biol 1985;12:267–274.
45.
Hall JG, Powers EK, McIlvaine RT, Ean VH: The frequency and financial burden of genetic disease in a pediatric hospital. Am J Med Genet 1978;1:417–436.
46.
Jaber L, Weitz R, Bu X, Fischel-Ghodsian N, Rotter J, Shohat M, Arthrogryposis multiplex congenita in an Arab kindred. Am J Med Genet 1995;55:331–334.
47.
Slatis HM, Reis RH, Hoene RE: Consanguineous marriages in the Chicago region. Am J Hum Genet 1958;10:446–464.
48.
Ruas PM, Freire-Maia N: Inbreeding effect on morbidity. 1. Three analyses (one with cousin and sib controls) of two surveys among Brazilian whites and negroes. Am J Med Genet 1984;18:381–400.
49.
Stoltenberg C, Magnus P, Lie RT, Daltveit AK, Irgens LM: Birth defects and parental consanguinity in Norway. Am J Epidemiol 1997;145:439–448.
50.
Cook R, Hanslip A: Mortality among offspring of consanguineous marriage in a rural area of east Jordan. J Trop Pediatr 1966;11:95–99.
51.
Tanaka K: Genetic studies on inbreeding in some Japanese populations. XI. Effects of inbreeding on mortality in Shizuoka. Jap J Hum Genet 1973;17:319–331.
52.
Saha N, Hamad RE, Mohamed S: Inbreeding effects on reproductive outcome in a Sudanese population. Hum Hered 1990;40:208–212.
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