Effects of Consanguineous Marriage on Fertility, Pregnancy Outcomes and on Health Status of Under–Five Year Children – A Rural Cross–Sectional Study

Abstract

Background and objectives ABSTRACT Marriage between two individuals who have at least one traceable common ancestor is said to be “consanguineous”. Consanguineous marriages have more chances of bringing rare recessive alleles together leading to various ill–effects such as infertility, repeated abortions, stillbirths, congenital malformations, mental retardations etc in children. The objectives of the present study are to know the prevalence of consanguineous marriage; fertility pattern, pregnancy outcomes and the effects of consanguinity on health status of under-five year children. Methodology The present study was conducted in Khaderwadi village which is one of the villages under Primary Health Centre Kinaye, adopted by J.N.Medical college, Belgaum. The study was conducted from 1 st IX January 2008 to 31 st December 2008. A total of 755 married women were interviewed using predesigned and pretested structured questionnaire and 474 under-five year children were clinically examined to assess their health status and presence of any congenital malformation. Results In the present study the prevalence of consanguineous marriage was 27.94%. The most common type of marriage was between cross-cousin ( 44.08% ) followed by uncle-niece ( 28.90% ) . The most common reason for consanguineous marriage was preference of mates within kin group ( 28.43% ) . The consanguinity was higher among illiterate women 109 ( 51.66% ) compared to women in non–consanguineous marriage 197 ( 36.21% ) . The parity ≥ 6 was higher 29 ( 13.75% ) in consanguineous marriage compared to non-consanguineous marriage where it was 34 ( 6.25% ) . The total number of pregnancies in consanguineous marriage was 770 out of which 48 ( 6.25% ) had abortions, 18 ( 2.33% ) still births and 704 ( 91.42% ) live births and in non- consanguineous marriage the total numbers of pregnancies were 1594 out of which 57 ( 3.57% ) had abortions, 17 ( 1.06% ) still births and 1520 ( 95.37% ) live births and was statistically significant. A significantly higher 63 ( 8.94% ) number of under-five mortality was seen in children in consanguineous marriage compared to 77 ( 5.05% ) in non-consanguineous. A higher number of participants gave congenital anomalies as the reason for under-five mortality in consanguineous marriage 21( 33.34% ) compared to non-consanguineous marriage 10 ( 12.98% ) . Out of 130 children in consanguineous marriage 4 ( 3.07% ) had mental retardation and epilepsy, 3 ( 2.30% ) mental retardation only, another 3 ( 2.30% ) had CHD, 2 ( 1.53% ) deaf mute, 2 ( 1.53% ) cleft lip and 1 ( 0.80% ) child had epilepsy. Out of 344 children in non-consanguineous marriage only 1( 0.29% ) child had mental retardation. A significant association was observed between consanguineous marriage and congenital morbidities like mental retardation, epilepsy, mental retardation with epilepsy and CHD. However, no such significant association was observed between deaf mute and cleft lip and consanguineous marriage. Conclusion In the present study, it was revealed that more than one fourth ( 27.94% ) of the marriages were between relatives. The consanguinity was associated with adverse pregnancy outcomes like abortions and still births. There was significant association between congenital morbidities and consanguinity. The under-five mortality was observed to be higher among the consanguineously married couples.