Croudace However, the study design allowed for a robust examination of the mental health risk associated with consanguineous parents: the data were population wide, capturing an entire cohort born over 15 years, and contained detailed neonatal information on the individual and detailed sociodemographic information on the parents. Role of the Funder/Sponsor: The funding sources had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. Until now consanguinity is widely practiced in several global communities with variable rates depending on religion, culture, and geography. The inclusion of second cousins raised the percentage of consanguineous marriages from 50.3 to 61.2. Likelihood ratio tests for interactions found no interaction between rurality and consanguinity (χ2 = 6.37, P = .38) or between deprivation and consanguinity (χ2 = 7.99, P = .63).  A, Dafeeah Female sex (odds ratio [OR], 1.35; 95% CI, 1.33-1.37) was associated with missing HCN, likely owing to marital name changes or migration since assignment of the original CHI. Consanguineous marriages have been practiced since the early existence of modern humans. A global reference for fetal-weight and birthweight percentiles. Peer review under responsibility of Ain Shams University.  A, Bhugra Do perinatal and early life exposures influence the risk of malignant melanoma? Comparison between genetic diseases with different modes of inheritance showed that recessive and multifactorial disorders had the highest values of consanguinity (78.8%, 69.8%, respectively), while chromosomal disorders had the lowest one (29.1%). After full adjustment for factors known to be associated with poor mental health, children of first-cousin consanguineous parents were more than 3 times as likely to be in receipt of medications for common mood disorders compared with children of nonrelated parents (OR, 3.01; 95% CI, 1.24-7.31). Bener Accepted for Publication: January 17, 2018.  G, Tamim Findings  We suggest that these findings will be of value to health promotion and public health professionals and to those commissioning antenatal, pediatric, and clinical genetic services. Multilevel Regression Models to Investigate the Likelihood of Antidepressant or Anxiolytic Medication Use Given Parental Consanguinity, Adjusting for the Clustering of Individuals Within GP Practices, Table 3.  J, Betran  H.  The effect of consanguineous marriage on mental health among the students of the Shahrekord University of Medical Sciences. The highest rates of consanguineous marriages occur in south and west Asia, Middle East, and north Africa. These results are listed in Table 1. Contribution of consanguinuity to polygenic and multifactorial diseases. Mair The final study data set comprised 363 960 individuals born between 1971 and 1986, alive and residing in NI in 2014, with full data on all variables (447 452 minus 74 738 with missing HCN, 3328 deaths, and 5426 with missing data) (eFigure in the Supplement). Chaleby Customize your JAMA Network experience by selecting one or more topics from the list below. [citation needed] Ayurveda states that marriage within the Gotra (father's side) is a consanguineous marriage which can lead to many gestational and genetic problems in the fetus. Key Points. New evidence regarding racial and ethnic disparities in mental health: policy implications.  F.  Socioeconomic inequalities and mental health problems in children and adolescents: a systematic review. a population-based study.  L, Newby  M, Wilkinson  HN, The HCN indicator was used to link the CHS with the EPD data set. First-cousin marriages are legal throughout the world with the exception of the United States, North Korea, and the People’s Republic of China.2 However, actual rates of consanguinity within populations are impossible to determine. Group IV: Diseases of different etiologies.  AF. Ethical approval was obtained from the Office for Research Ethics Committees Northern Ireland. The BNF is the standard reference digest for medications in the United Kingdom.42 Ever or never use was used for the main analysis, and sensitivity analyses were carried out using a cutoff of at least 3 months’ prescriptions, yielding similar results (eTable 1 in the Supplement). a Northern Ireland birth cohort analysis.  K.  The effect of consanguinity on neonatal outcomes and health.  TB, Ripke Premarital and pre-conceptional screening should be made mandatory in highly consanguineous populations for early identification of carrier state. It has been seen that in highly consanguineous regions there is a common and strong belief among people that marrying within the family reduces hidden uncertainties about health and financial issues. Family history, pedigree analysis, pre-marital counselling and screening, preconception counseling, and genetic testing should be preferred in highly consanguineous populations to prevent the adverse health outcomes of consanguinity.  E,  D.  Residential segregation, dividing walls and mental health: a population-based record linkage study. Copyright © 2013 Production and hosting by Elsevier B.V. Egyptian Journal of Medical Human Genetics, https://doi.org/10.1016/j.ejmhg.2013.01.002. Degree of parental consanguinity was assessed from questions asked of the parents during routine health visitor house calls within 2 weeks of the child’s birth. This study demonstrates the ability of population-wide data linkage to explore hard-to-reach populations, and we call on other countries with similar large-scale administrative data sources to use their data to explore the effects of consanguinity on offspring.  RA, Tansey A child of first-cousin consanguineous parents is at increased risk of common mood disorders and psychoses. Individuals with incomplete data in these fields may not have been successfully assigned an HCN. By continuing you agree to the use of cookies. Non-linear relationship between an index of social deprivation, psychiatric admission prevalence and the incidence of psychosis. Conclusions and Relevance  People should be educated and made aware about deleterious consequences of consanguinity. Individuals were classified as being in receipt of antipsychotic medication if they received at least 1 prescription for antipsychotics (British National Formulary [BNF] category 4.3.6) and were classified as being in receipt of medications for common mood disorders if they received at least 1 prescription for antidepressant medication (BNF category 4.3.4) or anxiolytic medication (BNF category 4.3.1) over the 5-year study period (2010-2014). Kessler © 2020 American Medical Association. eFigure.  et al. to download free article PDFs, Adult functional outcome of those born small for gestational age: twenty-six-year follow-up of the 1970 British Birth Cohort. The dates of analysis were June 1 to October 31, 2017. Terms of Use| Malaspina  JF, Fischer Fumeaux Some studies show that unexplained infant mortality and undiagnosed severe conditions in high consanguineous populations may be closely associated with inbreeding in these populations. Older age (OR, 3.09; 95% CI, 3.01-3.17 for 38-41 years compared with 26-29 years), SGA (OR, 1.88; 95% CI, 1.83-1.93), and first-cousin consanguineous parents (OR, 1.74; 95% CI, 1.35-2.25) were also associated with missing HCN, likely owing to the higher mortality risk in this group (eTable 2 in the Supplement). Strauss Parental age was defined as younger than 18 years, 18 to 35 years, and older than 35 years because parents younger than 18 years and older than 35 years have been identified as having a high risk of psychiatric morbidity in offspring.38-40 Maternal parity was also identified and categorized as firstborn, parity 1, parity 2, or parity 3 or more. In the study population, 0.2% of children were born to consanguineous parents, which is consistent with previous estimates of population consanguinity in Ireland and among Roman Catholic populations.26-28 Female sex, middle age, and deprivation were associated with receipt of antidepressant or anxiolytic medications, validating this measure because these factors are known in the literature to be associated with risk of depression and anxiety disorders.45,46 Children of first-cousin consanguineous parents were more than 3 times as likely to be in receipt of medications for common mood disorders compared with children of nonrelated parents. “It’s ok, we’re not cousins by blood”: the cousin marriage controversy in historical perspective. However, biological disadvantages supersede all the benefits as per present level of research and medical establishment. Risk of psychotropic medication use was also elevated in children of second-cousin consanguineous parents but was not statistically significant at the conventional 5% level (OR, 1.37; 95% CI, 0.79-2.40).  C, Diez Roux The prevalence of consanguinity in Morocco was found to be 15.25% with a mean inbreeding coefficient of 0.0065.  M, Published Online: April 4, 2018. doi:10.1001/jamapsychiatry.2018.0133. Fareed Bennett As consanguineous marriages may lead to transmission of lethal genes to progeny, they have many deleterious reproductive outcomes like congenital anomalies, cognitive impairment of vision and hearing problems, epilepsy, cystic fibrosis, hemoglobinopathies like sickle cell anemia and thalassemia, immuno-deficiency diseases, early onset of hypertension, cancer, still births, increased neonatal and infant mortality. Barrett Question   LJ. Shawky  Z, JAMA Psychiatry. In this population-wide cohort study of 363 960 participants, being a child of consanguineous parents was associated with having an increased likelihood of psychotropic medication use in adulthood. The prevalence of consanguineous parents recorded in this study is in keeping with other estimates,26-28 and the associations between mental health and a range of sociodemographic factors reflect those found in other studies worldwide.17,46-48 The analysis included regression modeling, adjusting for a range of confounders known to be associated with mental health, and multilevel modeling allowed for excellent adjustment of the potential unknown confounding associated with the natural clustering of individuals within GP practices.

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