24.7.2025
26.7.2025 Update
Krankheiten durch Inzucht
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Wenn eine derart vollfette Mutter darüber jammert, daß ihr Kind verhungert, dann ist an der Geschichte eine Menge faul.
1.
Frage an Grok:
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Welche durch Inzucht bewirkte Krankheit führt zu Abmagerung?
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Antwort von Grok:
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Eine durch Inzucht bedingte Krankheit, die zu Abmagerung führen kann, ist die **Progressive Retinaatrophie (PRA)**, die bei bestimmten Hunderassen durch Inzucht gehäuft auftritt. PRA führt zu einer fortschreitenden Degeneration der Netzhaut, was zur Erblindung führen kann. Betroffene Tiere zeigen oft begleitende Symptome wie Gewichtsverlust oder Abmagerung, insbesondere wenn sie aufgrund der Sehstörung weniger fressen oder gestresst sind.
Eine weitere mögliche Erkrankung ist die **Lysosomale Speicherkrankheit** (z. B. Mukopolysaccharidose), die bei inzuchtbedingter Häufung in manchen Tierpopulationen vorkommt. Diese Stoffwechselstörung kann zu Abmagerung, Wachstumsstörungen und anderen systemischen Problemen führen.
Falls du nach einer spezifischen Tierart oder einer menschlichen Krankheit suchst, lass es mich wissen, damit ich präziser antworten kann!
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Frage an Grok:
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Gibt es diese Krankheit auch bei Menschen?
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Antwort von Grok:
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Ja, lysosomale Speicherkrankheiten, wie z. B. Mukopolysaccharidose (MPS), gibt es auch bei Menschen. Diese genetischen Erkrankungen können durch Inzucht gehäuft auftreten, da sie meist autosomal-rezessiv vererbt werden, was bedeutet, dass beide Eltern Träger des defekten Gens sein müssen. Bei Inzucht steigt die Wahrscheinlichkeit, dass zwei Träger eines solchen Gens Nachwuchs bekommen, was die Krankheit manifest werden lässt.
Mukopolysaccharidosen (z. B. MPS I, II oder III) können zu Symptomen wie Wachstumsstörungen, Skelettverformungen, geistiger Behinderung und in manchen Fällen auch zu Abmagerung führen, insbesondere wenn der Stoffwechsel oder die Nahrungsaufnahme beeinträchtigt ist. Abmagerung ist jedoch nicht das Hauptsymptom, sondern tritt oft sekundär auf, z. B. durch chronische Erkrankungen oder Verdauungsprobleme.
Die Progressive Retinaatrophie (PRA) ist hingegen spezifisch für Tiere, insbesondere Hunde und Katzen, und hat kein direktes Äquivalent beim Menschen. Allerdings gibt es beim Menschen ähnliche erbliche Augenerkrankungen wie die **Retinitis pigmentosa**, die ebenfalls zu Sehstörungen und Erblindung führen können, aber nicht direkt mit Abmagerung assoziiert sind.
Falls du weitere Details zu einer spezifischen Krankheit oder ihrem Zusammenhang mit Inzucht beim Menschen möchtest, lass es mich wissen!
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Es ist eine bekannte Tatsache, daß bei Moslems die erzwungenen Heiraten im nahen Familienkreis einen ERHEBLICHEN Anteil an der Inzucht haben, und infolgedessen auch Ursache sind für die Erkrankungen, die im übrigen auch sehr stark gehäuft auftreten, unter anderem besondes in Pakistan, von wo auch statistische Daten bekannt sind.
2.
https://x.com/justdanaw/status/1948359584193876389
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Dana Weinstein @justdanaw
Unglaubliche Bilder: Der Inhalt von rund 950 LKWs, die von Israel kontrolliert und genehmigt wurden, verrottet auf der Gaza-Seite des Kerem Shalom-Übergangs, weil die UNO sich weigert, ihn zu verteilen.
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Heute hat der Humanitäre Fonds für Gaza (FHG) vorgeschlagen, die Hilfe anstelle der UN kostenlos zu verteilen, doch die UNO hat sich zurückgezogen.
Die UNO verhungert gemeinsam mit der Hamas die Menschen im Gazastreifen und schürt gleichzeitig die falsche Kampagne der "Hungersnot in Gaza" an.
Das gemeinsame Ziel von UN und Hamas: die Zerlegung der FHG zu erzwingen und der UN die alleinige Kontrolle über die Nahrungsmittelverteilung zu gewähren, wodurch sichergestellt wird, dass fast alle diese Hilfe in den Händen der Hamas landet, anstatt die Bevölkerung in Gaza zu erreichen.
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2:28 PM · Jul 24, 2025
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Update 26.7.2025
Das MUSS man lesen!:
"Hunger Games: Leserfrage"
von "U.M." (Joey Hoffmann )
https://steady.page/de/u-m/posts/a1e91fd8-4a2b-4d32-83dd-80b9240486df
29.7.2025
Inzucht in den Medien
Inzucht gibt es nicht nur im Islam, sondern besonders intensiv auch in den Medien. Weltweit! Immer und überall zieht eine Mafia Handlanger und Lautsprecher nach, ekelt und intrigiert Kritiker raus, und hirnwäscht und belügt die Bürger.
Lüge, Dein Name ist Medien.
Die Situation ist inzwischen staatsbedrohend geworden, auch im vorgeblich so aufgeklärten Europa. Die vierte Macht im Staat ist eine eigene Armee.
Und sie lügt. Unter anderem über Hungergreuel im Gaza-Streifen.
Zeit für Fakten.
Update, 30.7.2025:
https://x.com/WolfMalca/status/1950477058523488380
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malca goldstein-wolf @WolfMalca
Die New York Times muss nun zugeben, dass sie gelogen hat.
Das Kind, dass sie abgedruckt haben, litt natürlich nicht an Hunger, sondern an einer schweren Erkrankung.
Genaus das, was wir die ganze Zeit gesagt haben.
Für diese Wahrheit wurden wir beschimpft.
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10:42 AM · Jul 30, 2025
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Die Meldung der New York Times in eigener Sache:
https://x.com/NYTimesPR/status/1950311365756817690
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NYTimes Communications @NYTimesPR
We have appended an Editors' Note to a story about Mohammed Zakaria al-Mutawaq, a child in Gaza who was diagnosed with severe malnutrition. After publication, The Times learned that he also had pre-existing health problems. Read more below.
Children in Gaza are malnourished and starving, as New York Times reporters and others have documented. We recently ran a story about Gaza's most vulnerable civilians, including Mohammed Zakaria al-Mutawaq, who is about 18 months old and suffers from severe malnutrition. We have since learned new information, including from the hospital that treated him and his medical records, and have updated our story to add context about his pre-existing health problems. This additional detail gives readers a greater understanding of his situation. Our reporters and photographers continue to report from Gaza, bravely, sensitively, and at personal risk, so that readers can see firsthand the consequences of the war.
11:43 PM · Jul 29, 2025
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29.7.2025
Fakten: Krankheiten durch Inzucht / Inbreeding Islam
https://x.com/pseudowitch6/status/1630840836933013507
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Hamd Nawaz @pseudowitch6
Interesting thing about this disease [Thallassemia] is that it's saturated in some provinces and then, some families more than others. The families which have constant cousin marriages have an inbreeding of that gene. It means that you don't need to screen the entire population, only some.
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9:02 AM · Mar 1, 2023
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https://x.com/AJA_Cortes/status/1872044814671458559
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AJAC @AJA_Cortes
To be fair, Pakistan has the highest rate of consanguineous marriage in the world
Aka marrying your cousins
Aka Inbreeding
It's 65% plus of the population
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11:20 PM · Dec 25, 2024
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https://x.com/chawaching2/status/1947805453913592071
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Ethnomad @chawaching2
It is in response to your comment that actions don't define a race.
They do.
Inbreeding lowers IQ. It makes the race more likely to commit crimes, use drugs, and indulge in risky behaviour.
Over 60% of Pakistanis are inbred.
Why would you want a race like this in your country
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1:46 AM · Jul 23, 2025
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29.7.2025
Consanguineous marriages
I think that there is a wrong figure here:
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According to a rough estimate, nearly one billion (20%) of the global population live in communities with a preference for consanguineous marriages [1, 2],
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The world population is 8 billion people and not 5 billion.
Cousin marriages
65% Pakistan
55% India
50% Saudi Arabia
40% Afghanistan
30% Iran
20% Egypt
20% Turkey
This is a horrible burden with respect to body health and mental health.
https://bmcwomenshealth.biomedcentral.com/articles/10.1186/s12905-022-01704-2
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BMC Women's Health
Consanguineous marriages and their association with women's reproductive health and fertility behavior in Pakistan: secondary data analysis from Demographic and Health Surveys, 1990–2018
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https://bmcwomenshealth.biomedcentral.com/counter/pdf/10.1186/s12905-022-01704-2.pdf
Research article
Open access
Published: 14 April 2022
Consanguineous marriages and their association with women's reproductive health and fertility behavior in Pakistan: secondary data analysis from Demographic and Health Surveys, 1990–2018
Sarosh Iqbal, Rubeena Zakar, Florian Fischer & Muhammad Zakria Zakar
BMC Women's Health volume 22, Article number: 118 (2022) Cite this article
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Abstract
Background
Pakistan has been showing consistently the highest prevalence of consanguinity. The popularity of consanguineous marriages is not declining in the country, because of social, cultural, and religious beliefs as well as economic advantages. However, couples also face various health-related implications, such as poor pregnancy outcomes or multiple reproductive and fertility consequences, having adverse effects on mothers and their children. This research investigated the trend of consanguineous marriages and their association with women's reproductive health and fertility behavior in Pakistan from 1990 to 2018.
Methods
This study is based on secondary data analysis, using all four waves of the Pakistan Demographic Health Surveys carried out from 1990 to 2018. The analysis is limited to women aged 15–49 years, who had given birth in the previous five years preceding each survey. Sampling weights were calculated and subsequently weighted analysis was conducted. Descriptive statistics, bivariable and multivariable logistic regression analysis were performed to determine the association of consanguinity with multiple characteristics related to socio-demographics, co-variates, and women's reproductive health and fertility behaviors.
Results
The findings revealed a high but overall stable trend of consanguinity prevalence of about 63% during the last three decades. Consanguineous marriages were more prevalent amongst young and uneducated women, living in rural areas, with poorer wealth status and having less exposure to mass media to access information. A strong association of consanguinity was observed with women's reproductive health and fertility behavior, particularly for women who gave first birth at a younger age, had multi-gravida pregnancies, multi-parity, pregnancy termination, ANC visits, and higher fertility.
Conclusion
Consanguineous marriages are predominant in the patriarchal society of Pakistan. Findings revealed that consanguinity contributes significantly to women's reproductive health and fertility behaviors. Appropriate counseling, educational, and health promotional programs related to consanguinity should be designed and launched at the community level to raise awareness about risks towards women's reproductive health and fertility.
Peer Review reports
Background
Consanguinity is termed as wedlock or marriage between close blood relations or biological kin. Consanguineous marriages have been very common since the early existence of humanity. According to a rough estimate, nearly one billion (20%) of the global population live in communities with a preference for consanguineous marriages [1, 2], predominantly in Muslim countries of the Middle East, Africa, and South Asia [3, 4].
With 65%, Pakistan has one of the highest rates of cousin marriages globally, followed
by India (55%),
Saudi Arabia (50%),
Afghanistan (40%),
Iran (30%),
Egypt, and Turkey (20%) [5].
The prevalence of consanguineous unions differs amongst countries due to socio-demographic factors, such as geography (urban–rural residential community, isolated area, and population), religion, education, socio-economic status, a familial pattern towards early marriages, or consanguinity between parents [4, 6,7,8,9,10,11,12]. Although the incidence of consanguineous unions somehow decreased with urbanization, modernization, and smaller/nuclear families, however, it is still in practice [13].
Pakistan, a multi-cultural country with diverse caste systems, has been shown consistently the highest prevalence of consanguinity [14, 15]. Consanguineous marriages are encouraged in the country due to multiple reasons, e.g. to strengthen interfamily ties between close family members, a preference to the same caste and status, fear of incompatibility or difficulty in finding the right partner outside the family, security of being familiar with spouse and in-laws before marriage, restriction for socialization with the opposite gender, and financial constraints especially for dowry [16]. However, various socio-cultural and health-related implications have been identified for consanguineous couples [5]. Owing to shared alleles, consanguinity may lead to genetic disorders [17, 18], poor pregnancy outcomes, or multiple reproductive and fertility consequences, having adverse effects on mothers, their children, family, and society as a whole [5, 13]. A strong association of consanguineous marriages has been reported with increased rates of abortion, stillbirths, pregnancy terminations, low birth weights, increased mortality, and congenital malformations [13, 17, 19,20,21,22,23]. Furthermore, a low preference for contraception, extended childbearing age, and higher fertility has also been observed in such unions [8]. Although consanguineous marriages are also linked with poor pregnancy outcomes [22] and higher reproductive risks in Pakistan, nonetheless these are also associated with increased fertility rates and larger family size [24, 25].
Consanguineous unions have remained under continuous investigation by social scientists, medical researchers, biologists, and physicians. However, it received less attention in mainstream demographic research. Although multiple studies are available regarding the effects of consanguineous marriages on either reproductive health or fertility behaviors [22, 24, 25], nevertheless, there is a need to examine and explain the trends of consanguineous marriages and their association with women's reproductive health and fertility behavior in Pakistan. To our best knowledge, this is the first paper to examine trends in consanguineous marriages in Pakistan in recent decades. Therefore, this research is an attempt to investigate the differentials in reproductive health and fertility behaviors over almost three decades (1990–2018).
Methods
Study design and data source
This research performed secondary data analysis, using all four waves of Pakistan Demographic and Health Surveys (PDHSs), carried out during 1990–1991 (wave 1) [26], 2006–07 (wave 2) [27], 2012–2013 (wave 3) [28], and 2017–2018 (wave 4) [29]. These PDHSs are characterized as nationally representative and large-scale cross-sectional household surveys, conducted under the international series of MEASURE Demographic and Health Survey (DHS) Program and funded by the United States Agency for International Development (USAID). These surveys were carried out by the National Institute of Population Studies (NIPS) with the technical assistance of ICF International and the Pakistan Bureau of Statistics. A series of PDHSs is the largest household and publicly available dataset, with information on women's reproductive health, fertility behavior, marital status, and other socio-demographic variables. Each PDHS applied a random two-stage cluster sampling design, wherein firstly rural and urban sampling units were chosen, followed by the selection of eligible households with ever-married women (aged 15–49 years) [26,27,28,29].
Within each wave of PDHS, varied numbers of field teams collected data, each comprised of one male and three female interviewers, field editor, and supervisor. All teams were closely monitored by quality controllers, provincial/regional field coordinators, as well as the NIPS and ICF core team. Simultaneously, data editing, processing, and double data entry of completed questionnaires were also completed. Each wave of PDHSs used various questionnaires at household, community, women, and men levels for data collection. This research used the standard female questionnaire for data analysis, administered to women (aged 15–49 years), using the face-to-face method [26,27,28,29], and including questions about consanguinity, women's reproductive health, and fertility behaviors. The response rate was recorded between 93 and 94.5% for each wave of PDHS [26,27,28,29].
This research limited the analysis to the women of reproductive age (15–49 years), who had given birth in the previous years preceding each of the four PDHS waves from 1990 to 2018. Therefore, the sample size used for this study was 4,061, 5,677, 7,446, and 6,711, for 1990–1991, 2006–2007, 2012–2013, and 2017–2018, respectively.
Variables
Outcome variable: The outcome variable for this research is the marital status of respondents, i.e. non-consanguineous marriage versus consanguineous marriage. Further, types of consanguineous marriages were divided into three categories, including married to paternal first cousins, married to maternal first cousins, and married to relatives other than first paternal or maternal cousins.
Reproductive health and fertility behavior: Various variables related to women's reproductive health and fertility behavior were selected based on literature [1, 5, 8, 13, 19, 21, 22, 25]. These included age at first birth (< 20 years, 20–34 years, 35–49 years), gravidity (1–2, 3–5, 6 and above), parity (1–2, 3–4, 5 children, and above), number of living children (none, 1–2, 3–4, 5 and above), ever terminated pregnancy (yes/no), antenatal care (ANC) visits during last pregnancy (less than 4 visits, 4 visits and above), skilled birth attendants (SBA) at delivery during the last pregnancy (yes/no), ideal family size (1–2, 3–4, 5 and above), fertility intention/desired family size (wants more children, wants no more, i.e. undecided, sterilized, declared infecund), and current use of contraception (yes/no).
Sociodemographic characteristics and co-variates: The sociodemographic characteristics included geographical classification (urban, rural), regions/provinces (Islamabad, Sindh, Punjab, Khyber Pakhtunkhwa, FATA, Baluchistan, Gilgit Baltistan), respondent's age in years (15–24, 25–34, 35 years and above), education status (uneducated, primary, secondary, higher) as well as employment status of respondents and their husbands (unemployed, employed), and wealth quintile (richest, richer, middle, poorer, poorest). Other co-variates included exposure to mass media to access information (yes/no) and respondents' healthcare decision-making autonomy (yes/no).
Statistical analysis
Data analysis was conducted using SPSS version 21. Initially, sample weights were calculated and weighted analysis was performed. Descriptive statistics were presented in the form of frequencies and percentages. For bivariate analyses, cross-tabulation and chi-square tests were applied. Afterward, bivariable and multivariable logistic regression analyses were performed to measure the association of consanguineous marriages with sociodemographic characteristics, as well as women's reproductive health and fertility behaviors. During regression analysis, odds ratios (OR) and adjusted odds ratios (AOR) were calculated with a 95% confidence interval (CI). A p-value ≤ 0.05 was considered statistically significant.
Ethical considerations
Procedures and questionnaires for all DHS surveys have been reviewed and approved by ICF Institutional Review Board. Before each interview, an informed consent statement was read to the respondent, who had the chance to accept or decline to participate. The informed consent statements emphasized that participation is voluntary and provided details regarding the purpose of the interview, the expected duration of the interview, interview procedures, potential risks and potential benefits to respondents, as well as the contact information who could provide the respondent with more information about the interview.
Results
Sample characteristics
Table 1 highlights respondents' socio-demographic characteristics and other co-variates for the four PDHS waves from 1990 to 2018. The majority of women were of 25–34 years of age, uneducated (but with a lower trend over time: 79.2%, 64.6%, 55.8%, and 47.9%), and resided in rural areas (70.9%, 69.8%, 59.9%, and 66.5%). About three quarter or even more of the women were unemployed. Contrary to respondents, most of their husbands acquired a secondary level of education and almost all of them were employed. Although, findings revealed that about 60–70% of women had exposure to mass media, about half of the participants had no autonomy in healthcare decision-making.
Table 1 Sociodemographic characteristics and co-variates of respondents
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Trend of consanguineous marriages
Table 2 shows the proportion of consanguineous marriages amongst women of reproductive age from 1990 to 2018. Results indicate that about two-thirds of women were married to their cousins, more frequently with paternal first cousins than maternal ones. Findings revealed an overall stable proportion of consanguinity prevalence during the last three decades. However, even a slightly upward trend of consanguineous marriages was witnessed from 63.0% in 1990–1991 to 67.9% in 2007–2008, followed by a gradual downwards trend. Similarly, the pattern of marriages with paternal and maternal first cousins decreased during the period from 1990 to 2013, nonetheless, slightly increased in 2017–2018.
Table 2 Measures to describe consanguinity, reproductive health and fertility behavior
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Reproductive health and fertility behavior related characteristics
Table 2 demonstrates the characteristics related to women's reproductive health and fertility behavior from 1990 to 2018. Results indicated that the majority of respondents gave their first birth at an age below 20 years and had multi-gravida pregnancies between 3 and 5 times (44.5%, 43.3%, 43.4%, and 44.8%). Parity of 5 children and more decreased over time (41.2%, 35.7%, 31.1%, and 26.5%). The proportion of deliveries conducted by unskilled birth attendants during the last pregnancy constantly decreased from 81.5% in 1990–1991 to 28.0% in 2017–2018. Findings also revealed the gradual improvement in women's reproductive healthcare-seeking behaviors, particularly in availing at least 4 ANC visits and deliveries conducted by SBAs from 1990 to 2018. Furthermore, regarding women's fertility behavior, the analysis indicated that most of the women (68.8%) reported an ideal family size of 5 children and above in 1990, which decreased over time to 3–4 children in 2017–2018 (51.8%). Although about half of the respondents showed no more desire for children or fertility intention in all four waves, there was a high—but overall decreasing—rate of not using contraception (88.3%, 70.6%, 62.7%, and 63.9%).
Bivariate association of consanguinity with various factors
The association of consanguineous marriages with various factors—including sociodemographic characteristics, and reproductive health and fertility behaviors—amongst respondents of reproductive age in each of the four PDHS waves is presented in Table 3. Findings demonstrate the significant relationship of consanguinity with regions/provinces, urban/rural geographical classification, respondents' education, wealth quintile, mass media exposure, and healthcare decision-making autonomy in all waves. Respondents' age, employment status, and their husbands' educational status were also found statistically significant in most of the PDHS waves. Furthermore, results highlight the significant relationship of consanguinity with respondents' age at first birth, ANC visits, deliveries by SBAs, ideal family size, fertility intention, and current use of contraception in the majority of PDHS waves. In a few PDHS waves, a strong association of consanguineous unions was also observed with the number of living children, gravidity, and pregnancy termination.
Table 3 Relationship of consanguinity with sociodemographic characteristics, reproductive health and fertility behavior
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Bivariable and multivariable logistic regression
Table 4 depicts the results of the bivariable logistic regression analysis of consanguinity with respondents' sociodemographic characteristics, reproductive health, and fertility behaviors. Almost all sociodemographic variables in the four PDHS waves were significantly associated with consanguinity—at least one category per item. However, the husband's employment status was only significant for 2017–2018. Furthermore, gravidity and parity, and the number of children showed nearly no significant associations.
Table 4 Bivariable logistic regression of Consanguinity with sociodemographic characteristics, reproductive health and fertility behavior
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When interpreting the results of the multivariable logistic regression analysis (Table 5), one needs to keep in mind that not all variables and categories have been assessed in all four waves. However, the results highlight that respondent's age was not significantly associated with consanguinity. The region and geographical classification were significant predictors of consanguinity, except for 2017–2018. The impact of education was contrary between women and their husbands: Women with higher education had a lower likelihood for consanguineous marriages, whereas men with higher education were more likely to marry their relatives. The strength of the association for both variables reduced over time. Employment status both for women and their husbands showed inconclusive results—the only significant association was found for employed women showing a higher likelihood of consanguinity in 2012–2013 (AOR = 1.23, 95% CI 1.08–1.39, p < 0.01).
Table 5 Bivariable logistic regression of consanguinity with sociodemographic characteristics, reproductive health and fertility behaviour
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All significant values (p < 0.05) are marked in bold
In 1990–1991, the wealth index was not significantly associated with consanguinity, but for all other waves, a higher wealth quintile was linked with a lower likelihood of consanguineous marriages. For example, in 2012–2013 (AOR = 0.53, 95% CI 0.41–0.69, p < 0.01) and 2017–2018 (AOR = 0.47, 95% CI 0.35–0.62, p < 0.01) the likelihood was halved in the richest wealth quintile compared to the poorest one. There was no impact of mass media exposure and respondents' healthcare decision-making autonomy, except for 2012–2013, where women having decision-making autonomy were less likely to be married to relatives (AOR = 0.83, 95% CI 0.74–0.92, p < 0.01).
As already shown in the bivariable logistic regression models, respondents' age at first birth, gravidity and parity, and the number of children showed almost no or only in some years or categories significant associations. Nevertheless, there is a trend younger age at first birth and lower gravidity is linked with consanguineous marriages. In 1990–1991 and 2006–2007, a lower number of children was associated with a higher likelihood for consanguineous marriages, ever having terminated pregnancy was only significantly associated with a higher likelihood for consanguinity in 2012–2013 (AOR = 1.29, 95% CI 1.15–1.44, p < 0.01). Visits of ANC and deliveries by SBAs were also no significant predictors, except for single exceptions. However, an ideal family size of less than five children was almost entirely significantly associated with not marrying a relative. The use of contraceptives was not significantly associated with consanguineous marriages.
Discussion
With the advanced research and expansion of knowledge in public health and social sciences, the topic of consanguineous unions has received higher importance. From the beginning of mankind, consanguinity or close-kin marriages were socially and culturally deeply rooted. Although it is presumed that the rates of consanguineous marriages decline with modernization and literacy, this is not transferable to all countries [30]. Presently, consanguinity is widely popular and respected in many communities, particularly in Muslims [2, 3]. Pakistan ranks amongst those countries, where the highest prevalence of consanguinity is still in vogue [3, 22, 25]. This article examined the trends of consanguineous marriages over approximately three decades, from 1990 to 2018, and their association with women's reproductive health and fertility behavior in Pakistan. It is an effort to bridge the gap in existing literature, documenting the relevance of consanguinity with reproductive health and fertility behavior amongst women, who had given births in five years preceding each of the four PDHS waves.
The results showed a varied trend of consanguineous marriages in Pakistan, which increased from 63.0% in 1990–1991 to 67.9% in 2006–2007, however, declined to 66.2% during 2012–2013 and 63.6% in 2018. This highlights the fact that the popularity of consanguineous unions is not declining in the country, because of social, cultural, religious, and economic advantages, which outweigh the disadvantages given the population [31]. In particular, consanguinity promotes family stability, inheritance, and spouse compatibility, nonetheless lessens hidden financial risks [6, 7, 16, 32]. These results are similar to other studies, carried out in many subpopulations within Pakistan [33], such as northern Punjab [34, 35], southern Khyber Pakhtunkhwa [36], Balochistan [37], Kashmir [38], and also in other Arab countries [1, 39], Yemen [40], Qatar [41] and Algeria [42]. Contrary, these results are not consistent with some of the research, where a decreasing trend in consanguineous unions was reported over time [43, 44].
This research also reiterated that consanguinity is associated with sociodemographic characteristics, as results demonstrated that consanguineous marriages are more prevalent amongst uneducated women, living in rural areas, and with poorer wealth status. These findings are comparable to other studies, where less-educated women get married to their cousins at a younger age, particularly in poor traditional rural areas [10, 45,46,47,48]. This highlights the need to educate and empower young girls, enabling them to make better informed decisions for their reproductive life to ensure their well-being. Previous empirical results found a strong association of consanguineous unions with women's reproductive health and fertility behaviors. Findings demonstrated that those women who married their cousins were more likely to give first birth at a younger age (between 20 and 34 years). Although not entirely significant in our analysis, we can also confirm this result. Our findings correspond to the previous studies, showing that consanguinity is associated with higher fertility rates and larger family sizes, which affects the health of both mothers and children [5, 8, 13, 22, 24, 25], particularly in the case of younger women [49]. Thus, there is a need to educate communities about linkages of consanguinity with poor reproductive health, adverse impact on fertility outcomes, and overall family health. This research emphasizes educating families regarding implications of consanguinity and associated health risks, through increasing public awareness, providing informational material, promoting health education, and enhancing capacities of primary healthcare and outreach workers to counsel communities effectively on health and social issues related to consanguineous marriages. It is pertinent to actively engage all key stakeholders in the public and private sector, particularly healthcare providers, outreach workers, and social mobilizers to elucidate the health and social effects of consanguineous marriages and promote healthy mothers, children, and communities.
Limitations
Since this research analyzed the four waves of PDHS from 1990 to 2018, few variables were not uniform and found missing, particularly in PDHS 1990–1991 and 2006–2007, such as regions/provinces, mass media exposure, respondent's healthcare decision-making autonomy, and pregnancy termination. Due to the cross-sectional design, we are not able to draw any causal conclusions. When interpreting the results, one needs to consider that some of the variables might be predictors of consanguineous marriages (such as low education), whereas others are effects (such as visits of ANC and deliveries by SBAs) or both (such as ideal family size).
Conclusion
This research concludes that consanguineous marriages are predominant in Pakistan, particularly in the context of the large power structure and patriarchal society. Findings revealed that consanguinity is associated with sociodemographic characteristics and women's reproductive health and fertility behaviors in Pakistan. The high prevalence of consanguineous marriages and their implications on women's health is essential to be considered in health policies. Owing to dilute these prevailing socio-cultural practices, a nationwide public education program has to be conducted, engaging key stakeholders (including health managers, healthcare providers, and outreach workers) and highlighting the risk factors associated with consanguinity to minimize the adverse health outcomes. Further, there is also a dire need to actively engage public health and reproductive health professionals to promote the health and wellbeing of the female population. Healthcare providers, outreach workers, and social mobilizers may play a critical role in this regard, particularly in identifying the consanguineous couples within their serving community, counselling them and providing information on potential risk factors, and enabling them to make informed choices regarding their reproductive health. Appropriate counselling, health educational, and promotional programmes related to consanguinity should be designed and launched at health facilities and community level to build capacities of healthcare providers and raise awareness amongst the general population on danger signs. Though there are multiple socio-cultural and economic benefits of consanguinity perceived by women in Pakistan, improvements in health literacy and behavior change will endorse an attitudinal change in society.
Availability of data and materials
Data is available from the Demographic and Health Survey program: https://dhsprogram.com/.
Abbreviations
ANC:
Antenatal care
AOR:
Adjusted odds ratio
CI:
Confidence interval
OR:
Odds ratio
PDHS:
Pakistan Demographic and Health Survey
SBA:
Skilled birth attendant
SPSS:
Statistical Package for the Social Sciences
References
Tadmouri GO, Nair P, Obeid T, Al Ali TM, Al Khaja N, Hamamy HA. Consanguinity and reproductive health among Arabs. Reprod Health. 2009;6:17.
Article
PubMed
PubMed Central
Google Scholar
Bittles AH. The global prevalence of consanguinity. 2015. http://www.consang.net/index.php/Global_prevalence. Accessed January 31, 2020.
Riaz HF, Mannan S, Malik S. Consanguinity and its socio-biological parameters in Rahim Yar Khan District, Southern Punjab. Pakistan J Health Popul Nutr. 2016;35:14.
Article
PubMed
Google Scholar
Bittles AH, Black ML. Evolution in health and medicine Sackler colloquium: Consanguinity, human evolution, and complex diseases. Proc Natl Acad Sci USA. 2010;107(Suppl 1):1779–86.
Article
CAS
PubMed
PubMed Central
Google Scholar
Olubunmia O, Nevesb K, Badreldeenc A, Konjea JC. A review of the reproductive consequences of consanguinity. Eur J Obstet Gynecol Reprod Biol. 2019;232:87–96.
Article
Google Scholar
Teebi AS, Teebi SA, Porter CJ, Cuticchia AJ. Arab Genetic Disease Database (AGDDB): a population-specific clinical and mutation database. Hum Mutat. 2002;19(6):615–21.
Article
CAS
PubMed
Google Scholar
Anwar WA, Khyatti M, Hemminki K. Consanguinity and genetic diseases in North Africa and immigrants to Europe. Eur J Public Health. 2014;24(Suppl. 1):57–63.
Article
PubMed
Google Scholar
Bittles AH, Grant J, Sullivan SG, Hussain R. Does inbreeding lead to decreased human fertility? Ann Hum Biol. 2002;29(2):111–30.
Article
CAS
PubMed
Google Scholar
Hamamy H, Jamhawi L, Al-Darawsheh J, Ajlouni K. Consanguineous marriages in Jordan: why is the rate changing with time? Clin Genet. 2005;67(6):511–6.
Article
CAS
PubMed
Google Scholar
Bener A, Abdulrazzaq YM, Al-Gazali LI, Micallef R, Al-Khayat AI, Gaber T. Consanguinity and associated socio-demographic factors in the United Arab Emirates. Hum Hered. 1996;46(5):256–64.
Article
CAS
PubMed
Google Scholar
Sureender S, Prabakaran B, Khan AG. Mate selection and its impact on female marriage age, pregnancy wastages, and first child survival in Tamil Nadu. India Soc Biol. 1998;45(3–4):289–301.
CAS
PubMed
Google Scholar
Jaber L, Bailey-Wilson JE, Haj-Yehia M, Hernandez J, Shohat M. Consanguineous matings in an Israeli-Arab community. Arch Pediatr Adolesc Med. 1994;148(4):412–5.
Article
CAS
PubMed
Google Scholar
Metgud CS, Naik VA, Mallapur MD. Consanguinity and pregnancy outcome among rural pregnant women of Belgaum district. Nat J Commun Med. 2012;3(4):681–4.
Google Scholar
Agha N. Kinship in rural Pakistan: Consanguineous marriages and their implications for women. Women's Stud Int Forum. 2016;54:1–10.
Article
Google Scholar
Jones GW. Changing marriage patterns in Asia. Asia Research Institute Working Paper Series No 131. Asia Research Institute and Department of Sociology. National University of Singapore; 2010.
Qidwai W, Syed IA, Khan FM. Prevalence and perceptions about consanguineous marriages among patients presenting to family physicians, in 2001 at a Teaching Hospital in Karachi, Pakistan. Asia Pac Fam Med. 2003;2(1):27–31.
Article
Google Scholar
Devi ACP, Sudarsanam D. Role of consanguinity in mental retardation. Asian J Exp Biol Sci. 2011;2:162–4.
Google Scholar
McKusick V. Human genetics. 2nd ed. New Delhi: Prentice Hall of India Press; 1972.
Google Scholar
Zakar R, Zakar MZ, Aqil N. Adverse birth outcomes associated with consanguineous marriage in Pakistan. Int J Gynecol Obstet. 2014;127(2):211–2.
Article
Google Scholar
Hasnain SF, Hashmi SK. Consanguinity among the risk factors for underweight in children under five: a study from rural Sindh. J Ayub Med Coll Abbottabad. 2009;21(3):111–6.
CAS
PubMed
Google Scholar
Ullah MA, Husseni AM, Mahmood SU. Consanguineous marriages and their detrimental outcomes in Pakistan: an urgent need for appropriate measures. Int J Commun Med Public Health. 2018;5(1):1–3.
Article
Google Scholar
Omer S, Farooq S, Jabeen S. Effects of cousin marriages on adverse pregnancy outcomes among women in Pakistan: a secondary analysis of data from the Pakistan Demographic and Health Survey 2012–13. Pak J Women's Stud. 2016;23(1):65–76.
Google Scholar
RoyChoudhary AK. Incidence of in-breeding in different States of India. Demogr India. 1976;5:108–15.
Google Scholar
Shami SA, Schmitt LH, Bittles AH. Consanguinity, spousal age at marriage and fertility in seven Pakistani Punjab cities. Ann Hum Biol. 1990;17(2):97–105.
Article
CAS
PubMed
Google Scholar
Manzoor R, Imran W, Maken AM, Syed TH. Consanguineous marriages: Effects on pregnancy outcomes in Pakistan. J Dev Policy Res Pract. 2018;2:1.
Google Scholar
National Institute of Population Studies (NIPS). Pakistan Demographic and Health Survey (PDHS) 1990–91. Maryland: Macro International Inc.; 1991.
National Institute of Population Studies (NIPS). Pakistan Demographic and Health Survey (PDHS) 2006–07. Maryland: Macro International Inc.; 2007.
National Institute of Population Studies (NIPS). Pakistan Demographic and Health Survey (PDHS) 2012–13. Maryland: Macro International Inc.; 2013.
National Institute of Population Studies (NIPS). Pakistan Demographic and Health Survey (PDHS) 2017–18. Maryland: Macro International Inc.; 2018.
Baykara-Krumme H. Consanguineous marriage in Turkish families in Turkey and in Western Europe. Int Migration Rev. 2018;50(3):568–98.
Article
Google Scholar
Jaber L, Halpern GJ, Shohat M. The impact of consanguinity worldwide. Community Genet. 1998;1:12–7.
CAS
PubMed
Google Scholar
Bittles AH. Endogamy, consanguinity and community genetics. J Genet. 2002;81(3):91–8.
Article
CAS
PubMed
Google Scholar
Hussain R, Bittles AH. The prevalence and demographic characteristics of consanguineous marriages in Pakistan. J Biosoc Sci. 1998;30(2):261–75.
Article
CAS
PubMed
Google Scholar
Shami SA, Grant JC, Bittles AH. Consanguineous marriages within social/occupational class boundaries in Pakistan. J Biosoc Sci. 1994;26(1):91–6.
Article
CAS
PubMed
Google Scholar
Hina S, Malik S. Pattern of consanguinity and inbreeding coefficient in Sargodha district, Punjab, Pakistan. J Biosoc Sci. 2015;47(6):803–11.
Article
PubMed
Google Scholar
Wahab A, Ahmad M. Biosocial perspectives of consanguineous marriages in rural and urban Swat, Pakistan. J Biosoc Sci. 1996;28(3):305–13.
Article
CAS
PubMed
Google Scholar
Maian A, Mushtaq R. Consanguinity in population of Quetta (Pakistan): a preliminary study. Geography. 1994;5:49–53.
Google Scholar
Jabeen N, Malik S. Consanguinity and its socio-demographic differentials in district Bhimber, Azad Jammu Kashmir, Pakistan. J Health Popul Nutr. 2014;32(2):301–13.
PubMed
PubMed Central
Google Scholar
Al-Gazali LI, Bener A, Abdulrazzaq YM, Micallef R, Al-Khayat AI, Gaber T. Consanguineous marriages in the United Arab Emirates. J Biosoc Sci. 1997;29(4):491–7.
Article
CAS
PubMed
Google Scholar
Jurdi R, Saxena PC. The prevalence and correlates of consanguineous marriages in Yemen: Similarities and contrasts with other Arab countries. J Biosoc Sci. 2003;35(1):1–13.
Article
PubMed
Google Scholar
Bener A, Alali KA. Consanguineous marriage in a newly developed country: the Qatari population. J Biosoc Sci. 2006;38(2):239–46.
Article
PubMed
Google Scholar
Zaoui S, Biemont C. Frequency of consanguineous unions in the Tlemcen area (West Algeria). Sante. 2002;12(3):289–95.
PubMed
Google Scholar
Nath A, Patil C, Naik VA. Prevalence of consanguineous marriages in a rural community and its effect on pregnancy outcome. Indian J Community Med. 2004;29(1):41–3.
Google Scholar
Godhi SA, Metgud CS, Mallapur MD. Prevalence of consanguineous marriage and its effect on pregnancy outcome in a rural area. J Sci Soc. 2009;36:93–5.
Google Scholar
Bittles AH. The role and significance of consanguinity as a demographic variable. Popul Dev Rev. 1994;20(3):561–84.
Article
Google Scholar
Shah NM. Women's socioeconomic characteristics and marital patterns in a rapidly developing Muslim society. Kuwait J Comp Fam Stud. 2004;35(2):163–83.
Article
Google Scholar
Weinreb AA. Characteristics of women in consanguineous marriages in Egypt, 1988–2000. Eur J Popul. 2008;24(2):185–210.
Article
Google Scholar
Koc I. Prevalence and socio-demographic correlates of consanguineous marriages in Turkey. J Biosoc Sci. 2008;40(1):137–48.
Article
PubMed
Google Scholar
Güneş M, Selçuk H, Demir S, Ibiloğlu AO, Bulut M, Kaya MC, Yilmaz A, Atli A, Sır A. Marital harmony and childhood psychological trauma in child marriage. J Mood Disord. 2016;6(2):63–70.
Article
Google Scholar
Download references
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Funding
Open Access funding enabled and organized by Projekt DEAL. This research received no supporting funds from any funding agency in the public, commercial, or not-for-profit sector.
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Authors and Affiliations
Institute of Social and Cultural Studies, University of the Punjab, Lahore, Pakistan
Sarosh Iqbal
Department of Public Health, Institute of Social and Cultural Studies, University of the Punjab, Lahore, Pakistan
Rubeena Zakar
Institute of Public Health, Charité – Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
Florian Fischer
Institute of Gerontological Health Services and Nursing Research, Ravensburg-Weingarten University of Applied Sciences, Weingarten, Germany
Florian Fischer
University of Okara, Okara, Pakistan
Muhammad Zakria Zakar
Contributions
The study was conceptualized by SI and RZ. SI analysed the data, RZ and MZZ supervised data analysis. SI drafted the manuscript; RZ, FF and MZZ revised it critically for important intellectual content. All authors reviewed the final version of the manuscript.
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Correspondence to Florian Fischer.
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This study is based on secondary data analysis. However, for primary data collection, the study was approved by ICF Institutional Review Board. All participants provided written informed consent before data collection.
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The authors declare that no competing interests exist. FF serves on the Editorial Board of BMC Women's Health as Senior Board Member.
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Iqbal, S., Zakar, R., Fischer, F. et al. Consanguineous marriages and their association with women's reproductive health and fertility behavior in Pakistan: secondary data analysis from Demographic and Health Surveys, 1990–2018. BMC Women's Health 22, 118 (2022). https://doi.org/10.1186/s12905-022-01704-2
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Received01 September 2020
Accepted06 April 2022
Published14 April 2022
DOIhttps://doi.org/10.1186/s12905-022-01704-2
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Keywords
Consanguinity
Consanguineous union
Reproduction
Sexual and reproductive health
[...]
BMC Women's Health
ISSN: 1472-6874
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