Skip to main content

Advertisement

SpringerLink
Log in

Consanguineous Marriage and Early Pregnancy Loss in Rural to Peri-Urban India

  • Original Article
  • Published:
The Journal of Obstetrics and Gynecology of India Aims and scope Submit manuscript

Abstract

Background

Consanguineous marriage (CM) has been linked to spontaneous abortion (SAB), although studies have largely been cross-sectional and likely underestimated early loss. We aimed to determine the relationships between CM and SAB in a prospective pregnancy cohort study in Telangana State, India.

Methods

Data from 661 participants aged 15–35 years in the Longitudinal Indian Family hEalth (LIFE) study actively followed for pregnancy and pregnancy loss were analyzed. SAB was classified as early (< 8) or late (8–22) weeks gestation. We used logistic regression to model the relationships between CM, defined by first-cousin marriage, and SAB, adjusted for maternal age.

Results

Women in CM were at a modestly increased risk of any (ORadj 1.15, 95% CI 0.69, 1.91) and early (ORadj 2.03, 95% CI 0.85, 4.83) SAB compared to women in non-CM, although results were not statistically significant. There was no relationship between CM and late SAB.

Conclusion

Among couples in southern India, there was a modest increase in early but not late SAB among CMs which may be explained by the expected influence of chromosomal abnormalities and lethal homozygous recessive disease on early loss. Pre- and Peri-marital Health Counseling that addresses this risk may be warranted.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Bittles AH. Consanguineous marriage and childhood health. Dev Med Child Neurol. 2003;45:571–6. https://doi.org/10.1017/s001216220300104x.

    Article  CAS  PubMed  Google Scholar 

  2. Hamamy H, Antonarakis SE, Cavalli-Sforza LL, et al. Consanguineous marriages, pearls and perils: Geneva International Consanguinity Workshop Report. Genet Med. 2011;13:841–7. https://doi.org/10.1097/GIM.0b013e318217477f.

    Article  PubMed  Google Scholar 

  3. Badr FM. Genetic studies of Egyptian Nubian populations. I. Frequency and types of consanguineous marriages. Hum Hered. 1972;22:387–98. https://doi.org/10.1159/000152515.

    Article  CAS  PubMed  Google Scholar 

  4. Kumari N, Bittles AH, Saxena P. Has the long-predicted decline in consanguineous marriage in India occurred? J Biosoc Sci. 2019;52:1–10. https://doi.org/10.1017/S0021932019000762.

    Article  Google Scholar 

  5. Bittles, A. A background summary of consanguineous marriage. found at: http://consang.net/images/d/dd/01AHBWeb3.pdf (2001).

  6. Krishnamoorthy S, Audinarayana N. Trends in consanguinity in South India. J Biosoc Sci. 2001;33:185–97. https://doi.org/10.1017/s0021932001001857.

    Article  CAS  PubMed  Google Scholar 

  7. Bittles AH, Black ML. The impact of consanguinity on neonatal and infant health. Early Hum Dev. 2010;86:737–41. https://doi.org/10.1016/j.earlhumdev.2010.08.003.

    Article  CAS  PubMed  Google Scholar 

  8. Hussain R, Bittles AH, Sullivan S. Consanguinity and early mortality in the Muslim populations of India and Pakistan. Am J Hum Biol. 2001;13:777–87. https://doi.org/10.1002/ajhb.1124.

    Article  CAS  PubMed  Google Scholar 

  9. Zlotogora J, Shalev SA. The consequences of consanguinity on the rates of malformations and major medical conditions at birth and in early childhood in inbred populations. Am J Med Genet A. 2010;152A:2023–8. https://doi.org/10.1002/ajmg.a.33537.

    Article  PubMed  Google Scholar 

  10. Scott-Emuakpor AB. The mutation load in an African population. I. An analysis of consanguineous marriages in Nigeria. Am J Hum Genet. 1974;26:674–82.

    CAS  PubMed  PubMed Central  Google Scholar 

  11. Rao PS, Inbaraj SG. Trends in human reproductive wastage in relation to long-term practice of inbreeding. Ann Hum Genet. 1979;42:401–13. https://doi.org/10.1111/j.1469-1809.1979.tb00672.x.

    Article  CAS  PubMed  Google Scholar 

  12. 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;45:289–301. https://doi.org/10.1080/19485565.1998.9988980.

    Article  CAS  PubMed  Google Scholar 

  13. Garcia-Enguidanos A, Calle ME, Valero J, et al. Risk factors in miscarriage: a review. Eur J Obstet Gynecol Reprod Biol. 2002;102:111–9. https://doi.org/10.1016/s0301-2115(01)00613-3.

    Article  CAS  PubMed  Google Scholar 

  14. Brown S. Miscarriage and its associations. Semin Reprod Med. 2008;26:391–400. https://doi.org/10.1055/s-0028-1087105.

    Article  PubMed  Google Scholar 

  15. Al-Awadi SA, Naguib KK, Moussa MA, et al. The effect of consanguineous marriages on reproductive wastage. Clin Genet. 1986;29:384–8. https://doi.org/10.1111/j.1399-0004.1986.tb00509.x.

    Article  CAS  PubMed  Google Scholar 

  16. Ghosh AK, Majumder PP. Genetic load in an isolated tribal population of South India. Hum Genet. 1979;51:203–8. https://doi.org/10.1007/bf00287176.

    Article  CAS  PubMed  Google Scholar 

  17. Asha Bai PV, John TJ, Subramaniam VR. Reproductive wastage and developmental disorders in relation to consanguinity in south India. Trop Geogr Med. 1981;33:275–80.

    CAS  PubMed  Google Scholar 

  18. Jain VK, Nalini P, Chandra R, et al. Congenital malformations, reproductive wastage and consanguineous mating. Aust N Z J Obstet Gynaecol. 1993;33:33–6. https://doi.org/10.1111/j.1479-828x.1993.tb02048.x.

    Article  CAS  PubMed  Google Scholar 

  19. Kusneniwar GN, Margaret WR, Betha K, et al. Cohort Profile: The Longitudinal Indian Family hEalth (LIFE) Pilot Study, Telangana State, India Int J Epidemiol. 2017;46:788–789j. https://doi.org/10.1093/ije/dyw174.

    Article  CAS  PubMed  Google Scholar 

  20. Gary RJ. A class of K-sample tests for comparing the cumulative incidence of a competing risk. Ann Stat. 1988;16:1141–54.

    Google Scholar 

  21. Russo R, Sessa AM, Fumo R, et al. Chromosomal anomalies in early spontaneous abortions: interphase FISH analysis on 855 FFPE first trimester abortions. Prenat Diagn. 2016;36:186–91. https://doi.org/10.1002/pd.4768.

    Article  CAS  PubMed  Google Scholar 

  22. Hertz-Picciotto I. The evidence that lead increases the risk for spontaneous abortion. Am J Ind Med. 2000;38:300–9. https://doi.org/10.1002/1097-0274(200009)38:3%3c300::aid-ajim9%3e3.0.co;2-c.

    Article  CAS  PubMed  Google Scholar 

  23. Kumar S. Occupational, environmental and lifestyle factors associated with spontaneous abortion. Reprod Sci. 2011;18:915–30. https://doi.org/10.1177/1933719111413298.

    Article  CAS  PubMed  Google Scholar 

  24. Shawky RME, Mouchira EZ, Nour El-Din MS, et al. Consanguinity and its relevance to clinical genetics. Egypt J Med Hum Genet. 2013;14:157–64. https://doi.org/10.1016/j.ejmhg.2013.01.002.

    Article  Google Scholar 

  25. Puri S, Dhiman A, Bansal S. Premarital health counseling: A must. Indian J Public Health. 2016;60:287–9. https://doi.org/10.4103/0019-557X.195860.

    Article  PubMed  Google Scholar 

  26. Teebi, A. F., T. (Oxford University Press, Oxford Monographs on Medical Genetics No 30, 1997).

  27. Al-Gazali L, Hamamy H, Al-Arrayad S. Genetic disorders in the Arab world. BMJ. 2006;333:831–4. https://doi.org/10.1136/bmj.38982.704931.AE.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Funding

Funding

This project was supported by SHARE INDIA Research Foundation and their fundraising efforts and by the Fogarty International Center of the National Institutes of Health training program under Award Number D43 TW 009078.

Author information

Authors and Affiliations

  1. Department of Epidemiology, University of Pittsburgh, 130 Desoto Street, Pittsburgh, PA, 15261, USA

    Jamie M. Robertson PhD, MPH, Fouzia Farooq MPH, Clareann H. Bunker PhD, MPH & Catherine L. Haggerty PhD, MPH

  2. SHARE INDIA, MediCiti Institute of Medical Sciences, Ghanpur, Telangana State, 501401, India

    Kalpana Basany MD & P. S. Reddy MD

  3. Department of Biostatistics, University of Pittsburgh, 130 Desoto Street, Pittsburgh, PA, 15261, USA

    Xiaoqing Tan BS & Gong Tang PhD

  4. School of Medicine, University of Pittsburgh, 3550 Terrace Street, Pittsburgh, PA, 15261, USA

    P. S. Reddy MD

  5. Department of Surgery, Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115, USA

    Jamie M. Robertson PhD, MPH

  6. Department of Surgery, Brigham and Women’s Hospital, 75 Francis Street, Boston, MA, 02115, USA

    Jamie M. Robertson PhD, MPH

Authors
  1. Jamie M. Robertson PhD, MPH
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kalpana Basany MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Fouzia Farooq MPH
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Xiaoqing Tan BS
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Gong Tang PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Clareann H. Bunker PhD, MPH
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. P. S. Reddy MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Catherine L. Haggerty PhD, MPH
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Catherine L. Haggerty PhD, MPH.

Ethics declarations

Conflicts of interest

The investigators have no conflicts of interest.

Informed Consent

Informed consent was obtained for all participants in the study.

Ethics approval

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the 1964 Helsinki Declaration of and its later amendments or comparable ethical standards. This study was a population based prospective study and was approved by the Institutional Review Board of the MediCiti Institute of Medical Sciences (MIMS) hospital and was conducted within the tenets of the Declaration of Helsinki.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Dr. Jamie M. Robertson is an Instructor in Surgery at Harvard Medical School and the Direction of Innovation in Surgical Innovation in the Department of Surgery at Brigham and Women’s Hospital

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 (DOCX 27 KB)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Robertson, J.M., Basany, K., Farooq, F. et al. Consanguineous Marriage and Early Pregnancy Loss in Rural to Peri-Urban India. J Obstet Gynecol India 72, 314–321 (2022). https://doi.org/10.1007/s13224-021-01498-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13224-021-01498-7

Keywords

Search

Navigation