Ascertainment of consanguinity, neonatal outcome and morbidity in the population of Haripur district

Abstract

Consanguinity is a complex, controversial social and health care issue which is culturally favored in North Africa, West Asia and the Middle East. In addition to migrants from these populations now residing in Europe, Australia and North America also favor cousin marriages. Consanguinity is widespread in Pakistan but its prevalence is highly variable across different populations. Haripur is an important city of Hazara division of Khyber Pukhtunkhwa (KPK) and is the fourth populous city after Mansehra, Abbottabad and Batagram districts. In order to establish various biological aspects of consanguinity and inbreeding coefficient (IC-F), the present epidemiological study was carried out in Haripur district. A total of 1,500 random married females were recruited and information on marriage types, morbidity, congenital disorders, fertility and birth outcome was gathered. The present study revealed that consanguineous unions were 56% of the total marriages, yielding an inbreeding coefficient (IC-F) of 0.0295. The first cousin unions (FC) were the most predominant type of marriages (38.4%). Among the first cousin unions, parallel cousin unions and patrilineal unions were in the majority (57.5% and 51.4%, respectively), and father-brother-daughter (FBD) type had the highest representation (34.5%). The consanguineous unions were significantly associated with certain socio-demographic variables like spouse’s literacy, castesystem, family type, exchange or reciprocal marriages and subject’s age at marriage. However, no association of consanguineous unions was observed with subject’s origin, language, current age, literacy, occupational status, household system, marriage arrangement, and marriage year. These analyses further demonstrated that fertility and mortality were significantly higher in women who had consanguineous unions (CU) compared to the non-consanguineous (NCU) group (p=0.0137 and p=0.025, respectively). Significantly higher number of post-natal mortalities were calculated for the mothers who had CU (p=0.001) compared with the NCU sample. However, there were no differences in the distribution of CU and NCU samples with respect to livebirth sons and live-birth daughters. Fertility was also assessed with respect to various socio-demographic parameters. The total fertility and mortality rates were significantly associated with subject’s literacy, family type and subjects’ age at marriage. Furthermore, fertility, live-births, number of sons and daughters per women, mortality rate, pre-natal and post-natal mortalities were highest among consanguineous unions. The present epidemiological study also reports the congenital/hereditary disorders prevalence among the subjects. Among a variety of anomalies, neurological disorders were more prevalent (29%). The present study revealed the marked differences between the Haripur population and other populations of Pakistan with respect to the distribution of marriage types and inbreeding coefficient (IC-F). Consanguinity in Haripur was not as higher as reported for other regions of Pakistan. Further, consanguinity was significantly associated with fertility and mortality rates. This study would be helpful in determining the biosocial structure of Haripur population.