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PubMed2005

APOE2 and consanguinity: a risky combination for Alzheimer's disease.

OBJECTIVE: To investigate the association between APOE genotypes and Alzheimer's disease (AD) in elderly Indian subjects. The study also aims at the identification of consanguinity as disease risk factor for AD. METHODS: A total of 100 Indian patients (26 consanguineous, 74 non-consanguineous), meeting criteria for probable or definite AD and 36 cognitively healthy, elderly unrelated control subjects (spouses), were included in the study. The APOE genotyping and statistical analyses (SPSS 7.5) was performed to determine the odds of AD according to APOE genotype. RESULTS: The analysis revealed increased prevalence of E4 allele in patients as compared with controls. The difference in prevalence of E3 and E4 alleles was found to be statistically significant between consanguineous patients and controls as well as non-consanguineous patients and controls. Compared to individuals with the APOE3/3, the odds of having AD were significantly increased among those with one or more copies of the E4 allele, even after adjusting with age and sex. An interesting outcome of the study is the higher prevalence of the E2 allele in consanguineous AD patients (in contrast to previously reported studies). The risk for AD was higher in consanguineous individuals with E2/4 genotype (1.62 fold), as compared to non-consanguineous individuals. DISCUSSION: The Results support that the APOE4 allele plays a role as a risk factor for AD and suggests that the APOE2 allele may not play a protective role in the development of AD in Indians, especially individuals with family history of consanguinity. The study hypothesises that the consanguinity modifies the disease risk associated with E2 allele, although this allele is considered protective. The less number of subjects from a broader population limits the study. The wide-ranging population and ethnicity-based studies in the most inbred groups of the world may provide comprehensive insight into this conclusion.

Aged↗

PubMed1999

Parental consanguinity as a cause for increased incidence of births defects in a study of 238,942 consecutive births.

The risk for birth defects in the offspring of first-cousin matings has been estimated to increase sharply compared to non consanguineous marriages. As a general decline in the frequency of consanguineous marriages was observed in this century, one wonders whether consanguinity is still a factor in the appearance of birth defects in developed countries. Based on our registry of congenital anomalies we tried to answer to this question. In the population studied in North-Eastern France a consanguineous mating was known in 1.21% of the cases with congenital anomalies, vs. 0.27% in controls, (p < 0.001). The frequency of the malformations recorded paralleled the degree of consanguinity: out of 89 malformed children, 51 were seen in first-cousins mating (10.3 times more frequent than in offspring of non consanguineous couples), 17 in second-cousins marriages and 18 in more distant relatives mating. Three were uncle-niece marriage. Excluding known mendelian conditions these numbers were 73, 36, 17 and 17 respectively and the corresponding relative risk were 3.68, 3.01, 3.41 and 4.89 respectively. Therefore there is a negative dose-response effect between level of inbreeding and risk of congenital malformations. Consanguineous mothers were more often pregnant than non consanguineous mothers (p < 0.01) and they had more stillbirths than non consanguineous mothers. These results show that consanguinity is still a factor of birth defects and they must be taken into account for genetic counseling of inbred marriages, in developed countries.

Congenital Abnormalities↗

PubMed2000

Consanguinity, fertility, reproductive wastage, infant mortality and congenital malformations in Jordan.

OBJECTIVES: Consanguinity is a wide spread practice in Jordan. The objective of this study is to explore the health effects of consanguinity, in particular fertility, reproductive wastage, infant mortality and congenital malformations. METHODS: A stratified 2 stage cluster sample of 1867 married couples, representative of all population groups and all geographic locations of Jordan were randomly selected. A questionnaire was specially designed to explore each of the objectives set for the study and was field tested. A group of field workers were thoroughly trained on the implementation of this instrument. All 1867 couples were interviewed by these field workers and completed questionnaires were reviewed before data entry. Data analysis was carried out using SPSSX statistical package. Significance tests were performed wherever appropriate. RESULTS: The study showed that fertility, as measured by the number of pregnancies, taking into consideration marriage duration, was not affected by consanguinity. Twin pregnancies and abortions did not show any significant difference between consanguineous and non-consanguineous marriages. Consanguineous marriages showed significantly higher rates of still births and infant mortality in general. Within the consanguineous group, female infant mortality rates were significantly higher than those of males. Congenital malformations as reported by mothers of consanguineous marriages were significantly higher than those reported by mothers of non-consanguineous marriages. CONCLUSION: This study showed that consanguinity has a detrimental effect on many aspects of reproductive health.

Abortion, Spontaneous↗

PubMed1983

Age correlation between mates and average consanguinity in age-structured human populations.

When population geneticists wish to determine the genetic consequences of some aspect of mating behavior, it is often necessary to compare observed levels of consanguinity to the level expected when mating is random with respect to the factor being studied. Expectations under random mating are often derived from discrete generation models that ignore age structure. Observed frequencies of consanguineous matings are due to processes that are continuous in time and are affected by variables that are functions of age structure. The extent to which this discrepancy between the models and reality might distort conclusions drawn from comparisons of observed and expected behavior has received insufficient attention. One potential source of error is the tendency for people to choose mates whose ages differ from their own by a certain amount; this tendency influences the frequency of consanguineous matings. Age correlation between mates should therefore also affect average consanguinity between mates and average inbreeding in the population. Expected levels of consanguinity might then differ depending on whether or not age structure has been taken into account. Hajnal developed a model that predicts the frequencies of consanguineous matings in age-structured populations. Hajnal's model is extended here to include relationships that are defined by lineal descent as well as by common ancestry, and to allow calculation of the frequencies of consanguineous matings in the absence of age correlation between mates. The extended model is then used to determine the effect of age correlation between mates on average consanguinity under various sets of conditions. The magnitude of this effect depends on the degree to which the increased frequency of some types of consanguineous matings is offset by the decrease in other types of matings. There is a fairly wide range of conditions under which this compensation is nearly complete and therefore under which the overall effect of age correlation is small. But the size of this effect is sensitive to many factors, especially the distribution of age differences between mates and the variances of ages at maternity and paternity. Under some conditions, age correlation between mates will have a substantial effect on average consanguinity.

Age Factors↗

PubMed2005

Changing profile of couples seeking genetic counseling for consanguinity in Australia.

Consanguineous marriage is rare in most Western countries and, for example, in the USA it may be subject to regulation by both civil legislation and religious prescription. This is not the case in many regions of Asia and Africa where marriage within the family is strongly favored. Since the 1970s there has been widespread migration to North America, Western Europe, and Australasia from communities which encourage consanguineous marriage. To assess the effect of this trend on a genetic counseling program, the records of 302 couples referred to Genetic Services of Western Australia for consanguinity counseling were abstracted for the period 1975-2001. Overall, a family history of genetic disease or a previously affected child was reported in 28.8% of cases. Premarital or prepregnancy counseling on grounds of consanguinity was sought by 41.0% of couples, and a further 18.2% of consanguineous couples had been referred because of a consanguineous pregnancy. In 7.6% of cases a relationship closer than first cousin was involved. Through time there was a significant increase in the numbers of consanguineous consultants, and their patterns of religious affiliation and ethnic origin widened markedly. Although effectively excluded from entry to Australia prior to 1975, couples of Asian origin accounted for 25.5% of all consanguineous consultants. With ongoing migration, changes in the ethnic profiles and the specific counseling requirements of consanguineous couples can be expected to continue and probably accelerate.

Australia↗

PubMed1998

Consanguineous marriage in an urban area of Saudi Arabia: rates and adverse health effects on the offspring.

The objective of this cross-sectional study was to determine the pattern and time trend of consanguineous marriage and its adverse health effects on the offspring in Dammam city, Eastern Province, in the Kingdom of Saudi Arabia. This city is known to attract Saudis from different parts of the country because it is in the heart of this industrial region. Five primary health care centers were randomly selected from different sectors of the city in addition to the city's only Maternity and Children's Hospital. For inclusion in the study a wife must have at least one pregnancy that terminated in either full term liveborn baby, still birth, or abortion. A total of 1307 ever-married Saudis completed a pre-structured questionnaire during an interview. The rate of consanguineous marriage was 52.0% with an average inbreeding coefficient of 0.0312. First-cousin marriages were the commonest (39.3%) of all matings. The consanguineous groups had a significantly higher number of pregnancies. The mean birth weight of the offspring of consanguineous couples was not statistically significant being less than that of the non-consanguineous. However, within the consanguineous groups the more closely related couples had smaller babies on average. No significant differences were noted for the rates of inherited diseases and reproductive wastage. The rate of consanguineous marriage in this city was high and so was the inbreeding coefficient. These figures place this nation among the countries with a high rate of consanguineous marriages. A nationwide study to determine accurately the relationship between consanguinity and inherited diseases has much to commend it.

Abortion, Spontaneous↗

PubMedDate not supplied

An insight into recent consanguinity within the Basque area in Spain. Effects of autochthony, industrialization and demographic changes.

BACKGROUND: The importance of studying the genetic kinship of those human groups characterized by a deeply rooted ethnicity has traditionally been and still is an interesting goal of anthropological and population genetic studies. However, only a few surveys have aimed to learn about the impact of industrial development on the consanguinity of these populations and even those have concentrated on industrialized regions. This approach is worth analysing in Spain, where industrialization was late in relation to other western European countries. AIM: In this work we analyse the characteristics of inbreeding in Guipúzcoa from 1951 to 1995. This Basque province underwent industrial and tourist development earlier than other Spanish regions. It has the highest density of Basque speakers and has always occupied a central position within the map of distribution of the Basque language. Guipúzcoa is geographically placed in the core of the Basque area. SUDJECTS AND METHODS: Data on consanguineous marriages recorded in the province of Guipúzcoa between 1951 and 1995 were taken from Roman Catholic dispensations stored in the Diocesan Archives of San Sebastián, the province's capital city. Over the whole time period, a total of 1152 consanguineous marriages were registered. RESULTS: The high frequencies of first cousin (M22) (F = 1/16) and uncle-niece, aunt-nephew (M12) (F = 1/8) consanguineous marriages distinguish Guipúzcoa from the rest of Iberian populations. The M22/M33 ratio (with M33 being second cousins) has never dropped below 0.67, which represents a significant deviation from the expectation value of 0.25. When consanguineous marriages are classified according to marriage partner birthplaces interesting results emerge. Provincial endogamy shows the highest consanguinity rates (57%) and the proportion of M22/M33 is also rather high (0.63). However, a major contribution to the consanguinity levels and mean inbreeding coefficient recorded in Guipúzcoa over recent decades has been made by immigrant relative groups coming from other geographical areas of Spain. In this segment of population the observed M22/M33 rates are 1.44. CONCLUSIONS: This study shows again how important preferentiality (or avoidance) is in human consanguinity, and also how human groups, in spite of being spatially settled in the same territory, present differential attitudes for given consanguinity patterns.

Consanguinity↗

PubMed2006

Consanguineous unions and child health in the State of Qatar.

The aim of the study was to estimate the prevalence and sociodemographic predictors of consanguineous unions in the State of Qatar and to assess the association between consanguinity, fertility and child health. A representative sample of 1800 Qatari women aged > or =15 years was approached for the study. Of these, 1515 (84.2%) women agreed to participate. The consanguineous marriage rate was 54.0% with estimated population confidence limits of 52.3-55.7%. First cousin unions were the most common form of cousin marriage. The level of parental consanguinity (both in the respondent's parents and her parents-in-law) was quite high. In a multivariable analysis, both education of the respondent and her husband as well as parental consanguinity were found to be strong predictors of consanguineous unions in the index generation. Although fertility was high in both groups, the mean number of pregnancies was somewhat higher in respondents with first cousin unions. Concomitantly they also had a slighter higher rate of livebirths than women in non-consanguineous unions. The occurrence of asthma, mental retardation, epilepsy and diabetes was significantly more common in offspring of all consanguineous than non-consanguineous couples.

Abortion, Induced↗

PubMed1990

Consanguinity and its effect on fetal growth and development: a south Indian study.

The effect of consanguinity on fetal growth and development was studied in 3700 consecutive births (live and stillborn); 26% of the total births were to consanguineous couples. Hindus had a higher frequency of consanguineous marriages, uncle-niece unions being the commonest type, whereas Moslems preferred first cousin marriages. The incidence of congenital malformations was 39.1/1000 births with a significantly higher incidence among the consanguineous group (8.01%) as against the nonconsanguineous group (2.42%) (p less than 0.001). The incidence of malformations was higher in the uncle-niece matings (9.34%) compared to the first cousin marriages (6.18%) (p less than 0.01). Malformations of major systems were significantly more frequent among the consanguineous couples, whereas malformations of the eyes, ears, and skin did not show any significant effect of consanguinity. Stillbirth rates were significantly higher in the consanguineous group, irrespective of the mother's socioeconomic status, and were higher in uncle-niece matings compared to first cousin and beyond first cousin unions in both the poor and middle/upper class. A significant decrease in the mean birth weight and head circumference of babies born to consanguineous parents was noted in both the poor and middle/upper socioeconomic class. The mean length was less in babies born to consanguineous parents belonging to the poor social class only.

Abnormalities, Multiple↗

PubMed1997

Consanguinity and common adult diseases in Israeli Arab communities.

Consanguinity has a deleterious effect with regard to congenital malformation and rare autosomal recessive diseases; however, little information exists on its role in multifactorial common adult morbidity. We investigated the effects of consanguinity on the prevalence of common diseases in adulthood, including diabetes mellitus, myocardial infarction, bronchial asthma, and duodenal ulcer. As part of a larger study investigating the inbreeding coefficient in the Israeli-Arab community, we distributed questionnaires to parents of 4,100 second-grade students in 158 randomly chosen schools. Among the 3,772 responders (92%), 34.8% of the students' fathers and 31% of their mothers were found to be born to consanguineous matings. There was no difference in the prevalence (males, females) between the offspring of consanguineous versus non-consanguineous matings for diabetes mellitus (consanguinity: 4.3%, 1.5% vs. non-consanguinity: 2.9%, 1.6%) myocardial infarction (2.7%, 0.03% vs. 2.3%, 0.03%), bronchial asthma (2.4%, 2.0% vs. 3.7%, 2.3%), or duodenal ulcer (7.0%, 3.0% vs. 7.8%, 2.9%), respectively. The study suggests that even in a population with a high rate of consanguinity, there is no significant increase in the prevalence of these common adult diseases.

Adult↗

PubMed2001

Parental consanguinity in specific types of congenital anomalies.

Parental consanguinity, as a recognized risk factor for congenital anomalies, has mainly been studied with a focus on the types of parental relationships and their effects on genetic syndromes or birth defects in general. The present work analyzed the association between parental consanguinity and congenital anomalies, split, when possible, into clinical subtypes, in an attempt to obtain some insight into their recognized etiological heterogeneity. The material consisted of 34,102 newborn infants, affected by one of 47 selected congenital anomaly types, ascertained by the Latin-American Collaborative Study of Congenital Malformations (ECLAMC) during the period from 1967 to 1997. The consanguinity rate for each congenital anomaly type was compared with that of the population under study (0.96%), and the potentially confounding effect of six selected variables was controlled through a conditional logistic regression analysis for those congenital anomalies significantly associated with consanguinity. Pre-occurrence rates for the same congenital anomaly in sibships of consanguineous and non-consanguineous cases were compared. A significant association with parental consanguinity was observed for three congenital anomaly types: hydrocephalus, postaxial hand polydactyly, and bilateral cleft lip +/- cleft palate, while three additional anomalies, namely, cephalocele, microcephaly, and hand + foot postaxial polydactyly, showed a positive association, but statistical significance disappeared after adjustment for confounders, probably owing to sample size reduction. The association between consanguinity and Down syndrome was mainly due to the confounding effect of maternal age, while for hydrops fetalis and 2-3 toe syndactyly, the observed positive association could not be tested for confounders due to sample size reduction.

Cleft Lip↗

PubMed1994

Parental consanguinity as a cause of increased incidence of birth defects in a study of 131,760 consecutive births.

The risk for birth defects in the offspring of first cousin parents is substantially higher than in the offspring of non-consanguineous parents. As a general decline in the frequency of consanguineous marriages was observed in this century, one wonders whether consanguinity is still a factor in the appearance of birth defects in developed countries. Based on our registry of congenital anomalies, we think that the answer to this question is "yes." In the population studied in Northeastern France, consanguineous matings were known in 1.08% of the cases with congenital anomalies, vs. 0.28% in controls (P < 0.001). The frequency of the malformations recorded paralleled the degree of consanguinity: out of 38 malformed children, 24 were seen in first cousin matings (10.5 times more frequent than in offspring of nonconsanguineous couples), 8 in second cousin marriages, and 6 in more distantly consanguineous matings. Consanguineous mothers were more often pregnant than nonconsanguineous mothers (P < 0.01) and they had more stillbirths than nonconsanguineous mothers. These results must be taken into account when counseling consanguineous couples.

Congenital Abnormalities↗

PubMed2005

Inbreeding levels and consanguinity structure in the Basque province of Guipúzcoa (1862-1980).

This work analyzes the spatial heterogeneity of consanguinity in the Basque province of Guipúzcoa (Spain), using data provided by Catholic dispensations (1862-1980). Secular trends in consanguinity rates (%M(C)) and mean inbreeding coefficient (F) were similar in the seven Guipúzcoan regions considered, with peaks between 1881-1920 and subsequently a gradual decline. Substantial differences in consanguinity characteristics emerged when the regions were classified according to level of urbanization. Principal component analysis (accounting for more than 85% of the total variance in consanguinity variables) clearly discriminated between urbanized and less urbanized regions. The latter stand out for their high consanguinity rates (3.57-6.73%), mean inbreeding coefficient (0.00112-0.00240), and M22/M33 ratio (M22, first cousins; M33, second cousins), which ranged between 0.89-1.48. Moreover, in less urbanized regions, marital consanguinity was eminently local, and mainly conditioned by regional endogamy (71.4-85.0%). By contrast, urban subpopulations showed the lowest consanguinity rates (1.60-1.96%) and mean inbreeding coefficient (around 0.0007). In these regions, the M22/M33 ratio also exhibited high values (1.07-1.56), but this time at the expense of the contribution of the immigrant group. Discussion of the factors that could have modeled this spatial variation in consanguinity centers on: 1) demographic aspects related to the chronology and intensity of industrialization, 2) the geography of the territory and the geography of peopling, and 3) linguistic differences, expressed in the uneven distribution of Basque-speakers among the different territories considered.

Consanguinity↗

PubMed2005

Awareness about problems associated with consanguineous marriages: survey among Israeli Arab adolescents.

PURPOSE: To evaluate the level of knowledge among adolescents about the issues associated with consanguinity, because consanguineous marriages are widely practiced among Arabs, and are associated with an increased incidence of congenital malformations. METHODS: We carried out a national survey among 2933 students aged 15-16 years within the Israeli Arab community. Variables considered were gender, religion, location of residence, parents' level of education, number of siblings, whether their parents' marriage was consanguineous, whether any family members had congenital malformations, and the respondents' religious beliefs and traditions. Association among those variables and the level of knowledge that were statistically significant by univariate analysis were also assessed in a multivariate model. RESULTS: One-quarter of the students (24.5%) demonstrated a high level of knowledge, whereas 29.7% had a moderate level and 45.8% a low level. Overall, 81.5% knew that consanguinity was associated with a high incidence of congenital malformations, although only half of these (50.0%) knew what congenital malformations were and which were associated with consanguinity. The variables significantly associated with a low level of knowledge were gender, level of parents' education, consanguinity between the students' parents, and extreme religious attitudes. CONCLUSIONS: Efforts to increase the knowledge of Israeli Arab adolescents about consanguinity should therefore be especially directed toward males with parents who have a lower level of education, with parents who are consanguineous, and who have extreme religious attitudes.

Adolescent↗

PubMed2000

Sociodemographic correlates of consanguineous marriage in the Muslim population of India.

Using data derived from the 1992-1993 National Family Health Survey, the sociodemographic characteristics of consanguineous marriage were determined in the Muslim population of India. In this nationally representative sample of 8436 women, consanguineous marriages accounted for 22.0% of the total. No differences between the consanguineous and non-consanguineous groups were observed in terms of mean age at marriage or mean age at cohabitation. The study confirmed the negative association between consanguineous marriage and maternal education but also indicated that women in consanguineous unions were more likely to be employed, albeit mainly in agricultural work on behalf of the family. Consanguineous couples more frequently lived in smaller towns and in an extended family environment. Somewhat conflicting results were obtained with indicators of socioeconomic status, but the overall picture suggested that consanguineous households had greater access to consumer goods because of their larger number of co-resident persons.

Adolescent↗

PubMedDate not supplied

Consanguinity in the Bishopric of Ourense (Galicia, Spain) from 1900 to 1979.

BACKGROUND: Knowledge of the levels of inbreeding in the human population is interesting because it is one of the characteristics that conditions its genetic structure and has important genetic-medical repercussions in the descendants of marriages between close relatives. Galicia (north-west Spain) is a region with very special geographic, historic and social characteristics that makes it particularly interesting for consanguinity studies. PRIMARY OBJECTIVE: The object of this investigation is the study of the levels of inbreeding and the structure of consanguinity in rural area of the Dioceses of Ourense (Galicia) during the period 1900-1979. SUBJECTS AND METHODS: In the study, data corresponding to 437 parishes, integrated in 80 municipalities of the rural area of the Dioceses of Ourense were analysed. In the period studied, of a total of 110 128 marriages, 9010 took place between biologically related individuals up to the level of second cousins. The rate of consanguinity and the average coefficient of inbreeding of the population, as well as the percentage of the different types of consanguineous marriages, were calculated. MAIN OUTCOMES AND RESULTS: The rate of consanguinity for the period 1900-1979 is 8.18% and the average coefficient of inbreeding is 3.0662 x 10(-3). The most frequent type of consanguineous marriage is between second cousins (4.00% of all marriages). There is a notably high frequency of marriages of multiple relationships (0.52%) and the frequency of uncle-niece or aunt-nephew marriages is 0.16%. The average value of the M22/M33 ratio is 0.66 and during the 80 years studied, with regard to the temporal variation of the average coefficient of inbreeding, the annual values followed a polynomial curve with an inflection point in 1921. CONCLUSIONS: The highest values of consanguinity detected in Galicia, for the same period, were registered in the Dioceses of Ourense and the high rate of uncle-niece or aunt-nephew marriages habitual in this region was confirmed. The latter is explained by the important incidence in the Galician population of the migration to America at the end of the 19th and beginning of the 20th century. However, when the relative frequency of this type of marriage with respect to the total number of consanguineous marriages is calculated, it has relatively low values due to the high proportion of marriages between second cousins and marriages of multiple relationships, the highest in Galicia for an equal period of time. The rate of marriages between first cousins is also the highest in Galicia, confirming a phenomenon that appears to be common in the rural areas of the northern area of the Iberian Peninsula.

Consanguinity↗

PubMedDate not supplied

Consanguineous marriage in Iran.

Consanguineous marriage is a major feature of family systems in south-west Asia. The aim of the present study was to determine the current prevalence and patterns of consanguinity in Iran as a means of assessing the associated requirement for genetic counselling services. Consanguinity was studied in 12 ethnic/religious populations, the Persians (Shi'a and Sunni), Kurds (Shi'a and Sunni), Lurs, Azaris, Baluchis, Zabolis, Turkamans, Bakhtiaris, Ghashghais and Arabs. A multi-stage sampling design was used with a representative total sample of 306 343 couples. The overall rate of consanguineous marriage was 38.6% with a mean inbreeding coefficient (alpha) of 0.0185. First cousin marriages (27.9%) were the most common form of consanguineous union, with parallel patrilateral marriage especially favoured. Statistically significant differences were observed in the prevalence and patterns of consanguinity between ethnic/religious populations and geographical regions. There also were significant differences for proportions of consanguineous marriages between Shi'a and Sunni populations within the same ethnic group. The highest rates of consanguineous union were in the least affluent sections of the population.

Consanguinity↗

PubMed1993

Congenital malformations, reproductive wastage and consanguineous mating.

A study was undertaken in Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, South India, to understand the relation between congenital developmental disorders and consanguinity and also reproductive wastage and consanguinity. Four hundred children with existing congenital developmental disorders were studied with regard to their consanguineous parentage and compared with 1,000 randomly selected patients attending the paediatric outpatient department. There was a significantly higher prevalence of consanguinity in the study group (p < 0.001) and greater frequency in rural areas. The common types of consanguineous marriages were between first cousins (50.6%) and uncle and niece (42.4%). Frequency of consanguinity was not significantly related to religion and caste. The mean coefficient of inbreeding was 0.056. Consanguinity had no significant effect on average pregnancy rate and reproductive wastage. The frequency of consanguinity was significantly higher especially with autosomal recessive disorders (p < 0.001), congenital heart diseases (p < 0.001), multiple malformations (p < 0.001), neurological malformations (p < 0.005), chromosomal disorders (p < 0.01), genitourinary disorders (p < 0.02) and mental retardation-developmental disorders (p < 0.02). These observations stress the need for communicating the deleterious effects of inbreeding to the public through regular health education.

Abortion, Spontaneous↗