Objectives: The purpose of this paper is to explore the characteristics of mortality differences associated with consanguineous marriage among Palestinians in the Middle East. Methods: The data came from five surveys of Palestinians living in the West Bank and Gaza, Syria, Jordan and Lebanon, conducted during the period 1995–2000. Infant and child mortality was estimated for the offspring of consanguineous and non-consanguineous parents using the synthetic cohort method. Results: The data showed an increase in infant mortality of 15.0 additional deaths per 1,000 births among the offspring of first cousins, and a corresponding increase of 6.1 deaths per 1,000 for the progeny of parents from the same patrilineal clan. Conclusion: In populations where marriage within kin groups is common, both first cousin marriage and intra-group marriage carries an added risk of infant and child mortality.

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