Table 1 shows the frequencies and percentages of the degree of blood relation among respondents from the clinics.
Table 1
The clinical respondents’ degrees of consanguinity
Degree of consanguinity | Freq. | % | Cum % |
1st cousin (paternal uncle side) | 27 | 21.1 | 21.1 |
1st cousin (paternal aunt side) | 10 | 7.8 | 28.9 |
1st cousin (maternal uncle side) | 20 | 15.8 | 44.5 |
1st cousin (maternal aunt side) | 26 | 20.3 | 64.8 |
Double cousin (paternal uncle and maternal aunt side) | 12 | 9.4 | 74.2 |
Double cousin (maternal uncle and paternal aunt side) | 5 | 3.9 | 78.1 |
Second cousin | 12 | 10.2 | 88.3 |
Third cousin | 15 | 11.7 | 100 |
Table (1) here
Data showed that most respondents were married to their first cousins (78.1%). It also showed that 64.8% of the clinical sample married their first cousin (21.1% paternal uncle side, 7.8% paternal aunt, 15.8% maternal uncle side, and 20.3% maternal aunt side) and 13.1% married their double cousin (9.4% paternal uncle and maternal aunt side and 3.9% maternal uncle and paternal aunt side). The percentage of participants married to second and third cousins was 10.2% and 11.7%, respectively.
We examined the sociocultural and health attitudes of the clinical sample (consanguineous parents with at least one affected child with an AR genetic disease) and compared it with the community sample (non-consanguineous parents). Table 2 shows the differences in percentages between the two samples’ attitudes toward consanguineous marriage and how they regard consanguinity.
Table 2
The difference in percentages between the clinical and outside samples in sociocultural and health attitudes toward consanguinity
Sociocultural attitudes toward consanguinity | Clinic S | Outside S | P-value | Health attitudes toward consanguinity | Clinic S | Community S | P-value |
N (%) | N (%) | N (%) | N (%) |
1. Degree of consanguinity in the community: Common Uncommon Do Not Know | 88 (68.8) 7 (5.5) 33 (25.8) | 116 (75.3) 23 (14.9) 15 (9.7) | < 0.001 | 1. Death of a child because of genetic disease: Yes No | 97 (75.8) 31 (24.2) | 143 (94.1) 9 (5.9) | < 0.001 |
2. Prevalence of consanguinity: Increasing Decreasing No change Do Not Know | 34 (26.6) 28 (21.9) 42 (32.8) 24 (18.8) | 32 (20.8) 60 (39.0) 49 (31.8) 13 (8.4) | 0.004 | 2. Relationship between consanguinity and productive wastage: Agree Disagree Do Not Know | 43 (33.6) 0 (0.0) 85 (66.4) | 47 (30.7) 37 (24.2) 69 (45.1) | < 0.001 |
3. Consanguinity decrease divorce: Agree Disagree Do Not Know | 65 (51.6) 0 (0.0) 61 (48.4) | 67 (43.8) 41 (26.8) 45 (29.4) | < 0.001 | 3. Consanguinity increases genetic defects in children: Agree Disagree Do not know | 104 (81.3) 0 (0.0) 24 (18.8) | 120 (77.9) 13 (8.4) 21 (13.6) | 0.002 |
4. Supporting consanguinity: Agree Disagree Neutral | 23 (18.0) 65 (50.8) 40 (41.3) | 13 (8.4) 79 (51.3) 62 (40.3) | 0.038 | 4. Child’s health problem caused by: Consanguinity Unrelated Do not know | 96 (75.0) 2 (1.6) 30 (24.4) | 14 (9.5) 24 (16.3) 33 (22.4) | 0.000 |
5. Reaction to children deciding to marry relatives: Encourage them Advise against Does not affect decision | 26 (20.3) 75 (58.6) 27 (21.1) | 19 (12.4) 60 (39.2) 74 (48.4) | < 0.001 | 5. A 25% chance of genetic disease in children is acceptable: Agree Disagree Do not know | 62 (48.4) 55 (43.0) 11 (8.6) | 74 (48.4) 28 (18.3) 51 (33.3) | < 0.001 |
6. How common consanguinity is among your family: Common Middle Uncommon Do not know | 112 (87.5) 5 (3.9) 11 (8.6) 0 (0.0) | 32 (20.8) 67 (43.5) 40 (26.0) 15 (9.7) | < 0.001 | 6. Consider prenatal testing: Yes No Do not know | 43 (33.6) 69 (53.9) 16 (12.5) | 109 (72.7) 24 (16.0) 17 (11.3) | < 0.001 |
7. Importance of discussing consanguinity before marriage: Agree Disagree Do Not Know | 51 (39.8) 43 (33.6) 34 (26.6) | 112 (72.7) 20 (13.0) 19 (14.2) | < 0.001 | 7. Consider marriage pretests a good practice: Yes No Do not know | 123 (96.1) 3 (2.3) 2 (1.6) | 145 (94.8) 6 (3.9) 2 (1.3) | 0.746 |
Table (2) here
Regarding sociocultural attitudes, significant differences were found between the two groups (Table 2). Generally, parents with at least one child with a genetic disease (from the clinical sample) showed a positive sociocultural view concerning consanguineous marriage in society. Most clinical respondents (68.8%) believed consanguinity is common in Kuwait, while only 5.5% believed it is uncommon. On the other hand, 14.9% of the community sample believed that it is uncommon. Regarding the prevalence of consanguinity, significant differences were also found between clinical and community samples. In the clinical sample, 26.6% believed consanguinity is increasing in society, and 21.6% believed it is not. In contrast, 20.8% of the community sample believed that it is increasing while 39.0% thought it is decreasing. Almost half of the clinical sample (51.6%) agreed that consanguinity decreases divorce, none disagreed, and 48.4% did not know. At the same time, 43.8% of the community sample agreed that consanguinity decreases divorce, 26.8% disagreed, and 29.4% did not know. Respondents were asked if they support consanguinity in general. Significant differences were found between the two samples. Of the clinical sample, 18.0% supported consanguinity compared to 8.4% of the community sample. Of the clinical sample, 20.3% reported that they would encourage their children to marry a relative, compared to 12.4% of the outsider respondents. Data found that 87.5% of the clinical sample stated that consanguinity is common in their family, compared to only 20.8% of the outsider respondents. Finally, only 39.8% of the clinical respondents believed it important to discuss consanguinity with their children before marriage compared to 72.7% of the outsider respondents.
Regarding health attitudes, significant differences between the two samples were found in six out of seven examined variables (Table 2). Of the clinical respondents, 75.8% believed a child could die because of a genetic disease, while 94.1% of the outsider respondents believed the same. Regarding the relationship between consanguinity and productive wastage, 33.6% of the clinical sample agreed, none disagreed, and 66.4% did not know. On the other hand, 30.7% of the outsider respondents agreed, 24.2% disagreed, and 45.1% did not know. Most of the samples agreed that consanguinity increases genetic defects in children, but significant differences were found; of the clinical sample, 81.3% agreed, and none disagreed; of outsider respondents, 77.9% agreed, and 24.2% disagreed. Of the clinical respondents, 75.0% believed that children’s health problems could be caused by consanguinity, while only 9.5% of the outsider respondents believed this. Respondents were asked whether they had been informed that both themselves and their spouses carry a common pathogenic variant in a recessive gene with a 25% chance of having an affected child, it would be an acceptable possibility. Of the clinical sample, 43.0% disagreed that this is an acceptable possibility, while only 18.3% of the outsider respondents disagreed. Of the clinical respondents, only 33.6% would consider prenatal testing if there was a 25% chance that the fetus would be affected, compared to 72.7% of the outsider respondents. No significant differences were found between the two samples in the last variable, which was the respondent’s opinion of premarital carrier screening for common inherited genetic disorders. Most respondents (96.1% of the clinical and 94.8% of the outsider sample) considered the premarital carrier screening as a good practice.
Some variables were examined to see the differences between people who marry their relatives and those who do not: age at marriage, number of children, number of children with the same diseases in the family, and number of children’s deaths caused by genetic diseases. Table 3 shows these differences.
Table 3
The M, SD, and t values for clinical and outsider samples’ ages at marriage, number of children, number of children with the same diseases in the family, and number of children’s deaths caused by genetic diseases.
Variables | N | Age at marriage | Number of children | Number of children with the same diseases in the family | Number of children’s deaths caused by genetic diseases |
M | SD | P-value | M | SD | P-value | M | SD | P-value | M | SD | P-value |
Clinical sample | 128 | 22.91 | 3.75 | < 0.01 | 3.77 | 2.05 | .507 | 3.63 | 2.07 | < 0.001 | 1.78 | 1.13 | < 0.001 |
Community sample | 154 | 24.37 | 5.23 | 3.63 | 2.39 | 1.81 | 1.74 | .21 | .60 |
M: mean, SD: standard deviation |
Table (3) here
Data showed significant differences between consanguineous couples and non-consanguineous ones in their age at marriage, number of children with the same diseases in the family, and number of children’s deaths caused by genetic diseases. No significant differences were found in the overall number of children. Consanguineous couples visiting the clinic were married at a younger age at marriage, have higher numbers of children with the same diseases in the family and more likely to have lost their children due to genetic diseases compared to non-consanguineous families (Table 3).
Table 4 shows the relationship between the rate of consanguinity in the respondents’ family and education, income, number of persons with the same diseases in the family, and number of children’s deaths caused by genetic diseases.
Table 4
The relationship between the rate of consanguinity in the respondents’ family and some social and health variables
Variables | P-value |
Education | < 0.01 |
Family income | .090 |
Number of persons with the same diseases in the family | < 0.001 |
Number of children’s deaths caused by genetic disease | < 0.001 |
Table (4) here
No relationship was found between the rate of consanguinity in the respondents’ family and the family income. Our results show an inverse relationship between the rate of consanguinity and the respondent’s education level. On the other hand, it was found that a higher rate of consanguinity in the respondents’ families corresponds with higher numbers of persons with the same diseases in the family and children’s mortality secondary to genetic diseases.