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Consanguinity and the transmission/disequilibrium test for allelic association.

Consanguineous marriages, usually between first cousins or between uncle and niece, are common in certain societies. The transmission/disequilibrium test (TDT) compares the transmission from parents to an affected child of alleles at a marker locus, and differential transmission indicates linkage and allelic association between the marker locus and a disease locus. We investigate the consequences for the TDT, as a test for allelic association, of consanguineous marriages. For each parental marker mating type, we calculate the frequency of each disease mating type, and the associated probability that an offspring is affected. We use Bayes' Theorem to estimate the probability that an affected child inherits the given allele from a heterozygous parent, then combine our results across marker mating types. The effect of consanguineous marriage is usually small. For candidate genes, the effects were greater for uncle-niece marriages, for rare disease alleles, and for high genotype relative risk. For markers, the effects were generally negligible. The Type I error probability of the TDT is essentially unchanged by intermarriage, except for a purely recessive disease allele. The power of the TDT is increased for a recessive allele and decreased for a dominant allele. However, consideration of levels of consanguinity that arise in practice indicates that standard power calculations for the TDT will usually need only minor modification.

Bayes Theorem↗

Does consanguinity affect the severity of pre-eclampsia?

To determine whether consanguinity is more likely to be associated with severe forms of pre-eclampsia/eclampsia. Presuming a pure genetic contribution, we speculated that consanguineous marriages would increase the occurrence of severe forms of pre-eclampsia/eclampsia, through an expected increased chance for homozygosity to the putative gene. The study is a clinical case series on pre-eclamptic/eclamptic primiparae delivered at Princess Badea Teaching Hospital, which is a tertiary referral center. The internationally accepted definitions for hypertension, proteinuria, mild and severe pre-eclampsia were adopted. The study included 77 primiparae. The incidence of consanguinity in the studied sample was 38%. Of them, 28 (36.4%) had mild pre-eclampsia, 45 (58.4%) had severe pre-eclampsia and four (5.2%) had eclampsia. There was no statistically significant difference in the occurrence of severe pre-eclampsia/eclampsia between primiparae married to a first cousin or a relative other than a first cousin and primiparae married to a non-relative, odds ratio 1.1 (95% CI 0.33-3.87), P value 0.94, odds ratio 2.6 (95% CI 0.45-27.6), P value 0.30, respectively. Also, there was no statistically significant difference in occurrence of severe pre-eclampsia/eclampsia between primiparae whose parents are first cousins or relatives other than a first cousin and primiparae whose parents are non-relatives, odds ratio 1.3 (95% CI 0.36-4.72), P value 0.81, odds ratio 1.61 (95% CI 0.23-18.4), P value 0.70, respectively. Our study did not support a causal relationship between consanguinity and the occurrence of severe pre-eclampsia/eclampsia. The role of more complex genetic, immunologic, metabolic, hemostatic or, possibly yet, other unknown factors have to be explored.

Adolescent↗

Genomic insights from a deeply phenotyped highly consanguineous neurodevelopmental disorders cohort.

PURPOSE: The genetic underpinning of neurodevelopmental disorders (NDDs) in diverse ethnic populations, especially those with high rates of consanguinity, remains largely unexplored. Here, we aim to elucidate genomic insight from 576 well-phenotyped and highly consanguineous (16%) NDD cohort. METHODS: We used chromosomal microarray (CMA; N:247), exome sequencing (ES; N:127), combined CMA and ES (N:202), and long-read genome sequencing to identify genetic etiology. Deep clinical multivariate data were coupled with genomic variants for stratification analysis. RESULTS: Genetic diagnosis rates were 17% with CMA, 29.92% with ES, and 37.13% with combined CMA and ES. Notably, children of consanguineous parents showed a significantly higher diagnostic yield (P < .01) compared to those from nonconsanguineous parents. Among the ES-identified pathogenic variants, 36.19% (38/105) were novel, implicating 35 unique genes. Long-read sequencing of seizure participants unresolved by combined test identified expanded FMR1 trinucleotide repeats. Additionally, we identified 2 recurrent X-linked variants in the G6PD in 3.65% (12/329) of NDD participants. These variants were absent in large-population control cohorts and cohort comprising neurodevelopmental and neuropsychiatric populations of European descendants, indicating a possible associated risk factor potentially resulting from ancient genetic drift. CONCLUSION: This study unveils unique clinical and genomic insights from a consanguinity rich Bangladeshi NDD cohort.

Humans↗

High yield of monogenic short stature in children from Kurdistan, Iraq: A genetic testing algorithm for consanguineous families.

PURPOSE: Genetic testing in consanguineous families advances the general comprehension of pathophysiological pathways. However, short stature (SS) genetics remain unexplored in a defined consanguineous cohort. This study examines a unique pediatric cohort from Sulaimani, Iraq, aiming to inspire a genetic testing algorithm for similar populations. METHODS: Among 280 SS referrals from 2018-2020, 64 children met inclusion criteria (from consanguineous families; height &#x2264;&#xa0;-2.25 SD), 51 provided informed consent (30 females; 31 syndromic SS) and underwent investigation, primarily via exome sequencing. Prioritized variants were evaluated by the American College of Medical Genetics and Genomics standards. A comparative analysis was conducted by juxtaposing our findings against published gene panels for SS. RESULTS: A genetic cause of SS was elucidated in 31 of 51 (61%) participants. Pathogenic variants were found in genes involved in the GH-IGF-1 axis (GHR and SOX3), thyroid axis (TSHR), growth plate (CTSK, COL1A2, COL10A1, DYM, FN1, LTBP3, MMP13, NPR2, and SHOX), signal transduction (PTPN11), DNA/RNA replication (DNAJC21, GZF1, and LIG4), cytoskeletal structure (CCDC8, FLNA, and PCNT), transmembrane transport (SLC34A3 and SLC7A7), enzyme coding (CYP27B1, GALNS, and GNPTG), and ciliogenesis (CFAP410). Two additional participants had Silver-Russell syndrome and 1 had del22q.11.21. Syndromic SS was predictive in identifying a monogenic condition. Using a gene panel would yield positive results in only 10% to 33% of cases. CONCLUSION: A tailored testing strategy is essential to increase diagnostic yield in children with SS from consanguineous populations.

Humans↗

Recurrent early pregnancy loss and consanguinity.

The present authors have studied the possible relationship between recurrent miscarriage and consanguinity in the Qatari population, where the prevalence of first cousin marriage is 47%. The maternal of three or more early pregnancy losses were compared with those of 92 non-consanguineous women from the same population and with the same obstetrical history, matched for maternal age. The retrospective investigation showed no difference in the rate of previous pregnancy loss and maternal disorders, including diabetes, thyroid dysfunction and immunity, abnormal uterine and ovarian anatomy or thrombophilia. There was also no evidence of familial clustering of recurrent miscarriage in both groups. The prospective study showed no difference in the rate of subsequent pregnancy loss and the median gestational age and fetal weight at delivery in ongoing pregnancies. The absence of a relationship between recurrent miscarriage and consanguinity in Qatar could be due to the particular characteristics of the native Qatari population, in which rare recessive genes are uncommon, or overall to the absence of an association between recurrent miscarriage and consanguinity.

Abortion, Habitual↗

Biosocial perspective of consanguineous marriages in rural and urban Swat, Pakistan.

Consanguineous marriages in two population samples, one rural and one urban, from Swat (Pakistan) were studied. The frequency of consanguineous marriages was found to be 37.13% and 31.11%, and mean inbreeding coefficients were calculated as 0.0168 and 0.0162, for the rural and urban populations respectively. The most frequent type of marriage was between first cousins, in both samples. Among first cousin marriages, those with father's brother's daughter were predominant. Mean inbreeding coefficient was higher for higher socioeconomic groups in both samples. Differences by ethnic and educational groups were also found. Contrary to previous studies, a significant increase in the incidence of consanguineous marriages over the years has been observed. The incidence of premature mortality was significantly higher only in the offspring of first cousin marriages. Significantly higher incidence of morbidity in the offspring of consanguineous marriages was also observed.

Congenital Abnormalities↗

Is consanguineous marriage religiously encouraged? Islamic and Iranian considerations.

Consanguineous marriage has had considerable attention as a causative factor in the prevalence of genetic disorders. Iran, with its majority Muslim population, has a high rate of consanguineous marriage. In Iranian tradition, first cousin marriage is an acceptable and appreciated custom. However, there seems to be no encouragement of consanguineous marriage in the Islamic context; it is merely mentioned as a traditional and common custom. This paper may help medical professionals providing premarital genetic counselling, who are regularly asked about consanguineous marriage, especially in Islamic communities. Increased public awareness via the mass media would seem to be a priority.

Consanguinity↗

Consanguinity and its relationship to differential fertility and mortality in the Kotia: a tribal population of Andhra Pradesh, India.

Data on patterns of marriage, differential fertility and mortality were collected from 211 Kotia women residing in Visakhapatnam district of Andhra Pradesh, India. Consanguineous marriages made up just over a quarter of the total, and of these, father's sister's daughter (FSD) were more common than mother's brother's daughter (MBD). The mean inbreeding coefficient for the sample (F) was 0.0172. Women in consanguineous marriages had a lower mean number of total conceptions, live births and living offspring (net fertility) than women in non-consanguineous marriages. Significant heterogeneity was found in the means of living offspring for FSD, MBD and non-consanguineous couples, but not for conceptions and live births.

Birth Rate↗

Community perceptions of reasons for preference for consanguineous marriages in Pakistan.

Although the recent Pakistan Demographic and Health Survey (DHS) show that two-thirds of marriages in Pakistan are consanguineous, the sociocultural determinants of such marriages remain largely unexplored. This paper examines the relative importance of the three commonly perceived reasons for such marriages: religious, economic and cultural. The analysis is based on qualitative data collected in 1995 from multi-ethnic and multi-religious communities in Karachi, the largest city of Pakistan. Results show that consanguineous marriages are preferred across all ethnic and religious groups to a varying degree, and that parents continue to be the prime decision-makers for marriages of both sons and daughters. The major reasons for a preference for consanguineous marriages are sociocultural rather than any perceived economic benefits, either in the form of consolidation of family property or smaller and less expensive dowries. Among Muslims, following religious traditions is the least commonly cited reason for such marriages. Despite the reported sociocultural advantages of consanguineous marriages, such unions are perceived to be exploitative as they perpetuate the existing power structures within the family.

Adolescent↗

Consanguinity and its relevance to clinical genetics.

Marriage between close biological relatives is generally regarded with suspicion and distaste within Western society, reflecting historical and religious prejudice. By comparison, in many other populations there is a strong preference for consanguineous unions, most frequently contracted between first cousins, and marriage outside the family is perceived as a risky and disruptive option. The increasing importance of the genetic contribution to the overall disease profile in both developed and developing countries has highlighted potential problems associated with detrimental recessive gene expression in consanguineous progeny. This review examines the outcomes of consanguineous unions, with proposals as to how the ongoing preference for consanguinity in many communities can best be accommodated from a clinical genetics perspective.

Consanguinity↗

The influence of past endogamy and consanguinity on genetic disorders in northern Sweden.

It has been widely believed that consanguineous marriage was infrequent in northern Europe. As part of ongoing studies into the population structure of northern Sweden, the Demographic DataBase of Umeå University has undertaken digitization of the parish record books of the Swedish Lutheran Church, which date back to the late 17th century. To examine the prevalence and patterns of consanguineous marriage, information from the DataBase was abstracted for the Skellefteå region during the period 1720-1899 and extended family pedigrees constructed. Of the 14,639 marriages recorded, 3,043 (20.8%) were between couples related as sixth cousins or closer. Following changes in the Swedish civil law in 1844 that removed the requirement of royal dispensation for first cousin unions, a significant increase in first cousin marriages occurred during the next two generations, even though the total population of the region grew significantly. There was also strong evidence that consanguineous marriages were favoured within particular families. The findings of the study are consistent with the patterns of single gene disorders reported in specific communities in the region, and they suggest that founder effect, drift and consanguinity all were important influences on population genetic structure in previous generations.

Consanguinity↗

An analysis of consanguineous marriage in the Muslim population of India at regional and state levels.

Consanguineous marriage is widely favoured in a large majority of the world's Islamic populations. According to recent estimates, the resident Muslim population of India is over 100 million. However, apart from a few numerically small or geographically defined surveys, little is known about their patterns of marriage preferences since partition of the Indian Subcontinent in 1947. This study seeks to determine the prevalence and patterns of consanguineous marriages contracted among Indian Muslims at regional and state levels during the last two generations. Data from the 1992/93 Indian National Family Health Survey (NFHS) were used in the analysis. The NFHS was a nationally-representative survey of ever-married women aged 13-49 years, conducted across 25 states of India. Of the initial 9845 respondents, 8436 were included in the final weighted analysis sample. Overall, 22.0% of marriages were found to be contracted between spouses related as second cousins or closer, ranging from 15.9% in the eastern states to 32.9% in the western states of India. In all parts of the country first cousin marriages were the preferred form of consanguineous union, and in four of the five regions paternal first cousin marriages predominated. Despite predictions to the contrary, there was no evidence of a significant change in the prevalence of consanguineous unions over the course of the study period, which extended from the late 1950s to the early 1990s.

Adolescent↗

Consanguinity, twinning and secondary sex ratio in the population of Karnataka, south India.

Consanguineous marriages are strongly favoured in the state of Karnataka. Of 65,492 marriages studied 33.07% were consanguineous, equivalent to a coefficient of inbreeding (F) of 0.0298. The twinning rate was low, 6.9 per thousand, whereas the secondary sex ratio, 0.5221, was higher than in comparable major human populations. Consanguinity exerted no significant effect on either parameter. The results also indicate that consanguinity is not associated with excess antenatal losses and suggest the possibility of enhanced selection against mutations at X chromosome loci.

Consanguinity↗

Consanguinity and reproductive behaviour in a tribal population 'the Baiga' in Madhya Pradesh, India.

We have studied the marriage pattern and reproductive behaviour in a single Central Indian primitive tribe, the Baiga. Parents were consanguineous in 34% of marriages (19.2% mother's brother's daughter (MBD), 13.1% father's sister's daughter (FSD) and 1.7% were double first cross-cousins (DFCC). Fertility levels were significantly higher (p < 0.05) in related couples (4.7 offspring/couple) than unrelated couples (4.2/couple). Mortality (up to 20 years) was 19%. In the offspring of consanguineous couples it was higher (19.7%) than in the offspring of unrelated couples (18.6%) but the difference was not statistically significant. In consanguineous couples the reproductive period was longer than in unrelated couples, probably to allow compensation for increased reproductive losses (infant and childhood deaths). The level of social as compared to genetic parenting was about 35% as measured by tracking the inheritance of sickle gene, and allowance must be made for this in assessing the influence of consanguineous marriage on fertility and mortality.

Adolescent↗

Consanguinity and apnea of prematurity.

Consanguinity, marriage between relatives, has been associated with perinatal mortality and morbidity. Apnea of prematurity is defined as the cessation of breathing for longer than 20 seconds or that of any duration if accompanied by cyanosis and sinus bradycardia, for infants born before 37 weeks of gestation. The objective of the study was to examine the association between consanguinity and apnea of prematurity in Greater Beirut, an area having a relatively high prevalence rate of consanguineous marriages. The study was cross-sectional. Between September 1, 1998, and March 31, 2001, 21723 newborn infants were admitted to the National Collaborative Perinatal Neonatal Network in Greater Beirut, Lebanon. The inclusion criteria were infants less than 37 weeks of gestation who were admitted to the intensive care unit, with no congenital malformations, sepsis, or neurologic disorders. Analysis was based on 597 infants of whom 66 had apnea of prematurity. With adjustment for weeks and type of gestation, pregnancy complications, and Apgar score, the odds ratio of apnea of prematurity for first-degree consanguineous parents as compared with other marriages was 2.9 (95% confidence interval: 1.3, 6.4). In addition to the recognized etiologic factors for apnea of prematurity, this study suggests a role played by genetic factors.

Adult↗

Consanguineous marriage and its relevance to obstetric practice.

At the beginning of the twenty-first century, consanguineous marriage is practiced widely in many parts of the world. More than 2 billion people, of various religious and ethnic backgrounds, live in countries where a large proportion of marriages are contracted between blood relatives. The practice is seen as promoting family stability and having significant social and economic advantages. Consanguineous marriage is important genetically-the children of consanguineous unions are more often homozygous for particular alleles than are the offspring of unrelated parents, and therefore, autosomal recessive disorders, which may be lethal or debilitating, are more common in such children. Health-care providers working with communities where consanguineous marriage is common, in particular obstetricians, family physicians, and pediatricians, need to be aware of the possible impact of such marriages on pregnancy outcomes, so the best possible genetic and antenatal care can be provided, sympathetically and nonjudgmentally, and the best possible results obtained.

Consanguinity↗

A recent survey of consanguineous marriages in Japan.

A survey of consanguineous marriages in Japan was conducted on September 1 in 1983 through questionnaires. The total number of couples studied was 9,225 chosen from six widely different areas of Japan. The rates of first cousin marriages and of total consanguineous marriages for all areas are 1.6% and 3.9%, respectively. The mean inbreeding coefficient is 0.00134 for all areas of Japan. On the other hand, the rate of total consanguineous marriages was ten times higher in Fukue-Shi (7.9%) than in Asahikawa city area (0.78%). The rate of total consanguineous marriages is decreased with the marriage year in Japan, where the rate of first cousin marriages has changed remarkably.

Consanguinity↗

Reproductive behavior and health in consanguineous marriages.

In many regions of Asia and Africa, consanguineous marriages currently account for approximately 20 to 50% of all unions, and preliminary observations indicate that migrants from these areas continue to contract marriages with close relatives when resident in North America and Western Europe. Consanguinity is associated with increased gross fertility, due at least in part to younger maternal age at first livebirth. Morbidity and mortality also may be elevated, resulting in comparable numbers of surviving offspring in consanguineous and nonconsanguineous families. With advances in medicine and public health, genetic disorders will account for an increased proportion of disease worldwide. Predictably, this burden will fall more heavily on countries and communities in which consanguinity is strongly favored, as the result of the expression of deleterious recessive genes. However, studies conducted in such populations indicate that the adverse effects associated with inbreeding are experienced by a minority of families.

Congenital Abnormalities↗