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      Genetic and reproductive consequences of consanguineous marriage in Bangladesh

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          Abstract

          Introduction

          This study aimed to assess the prevalence, sociodemographic factors, reproductive consequences, and heritable disease burdens associated with consanguineous marriage (CM) in Bangladesh.

          Methods

          A total of 7,312 families, including 3,694 CM-families, were recruited from 102 locales of 58 districts of Bangladesh. Using a standard questionnaire, we collected medical history and background sociodemographic data of these families. Family history was assessed by pedigree analysis. Fertility, mortality, secondary sex ratio, selection intensity, lethal equivalents were measured using standard methods.

          Results

          The mean prevalence of CM in our studied population was 6.64%. Gross fertility was higher among CM families, as compared to the non-CM families ( p < 0.05). The rate of under-5 child (U5) mortality was significantly higher among CM families (16.6%) in comparison with the non-CM families (5.8%) ( p < 0.01). We observed a persuasive rise of abortion/miscarriage and U5 mortality rates with the increasing level of inbreeding. The value of lethal equivalents per gamete found elevated for autosomal inheritances as compared to sex-linked inheritance. CM was associated with the incidence of several single-gene and multifactorial diseases, and congenital malformations, including bronchial asthma, hearing defect, heart diseases, sickle cell anemia ( p < 0.05). The general attitude and perception toward CM were rather indifferent, and very few people were concerned about its genetic burden.

          Conclusion

          This study highlights the harmful consequences of CM on reproductive behavior and the incidence of hereditary conditions. It essences the need for genetic counseling from premarital to postnatal levels in Bangladesh.

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          Most cited references93

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          Coefficients of Inbreeding and Relationship

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            Evolution in health and medicine Sackler colloquium: Consanguinity, human evolution, and complex diseases.

            There is little information on inbreeding during the critical early years of human existence. However, given the small founding group sizes and restricted mate choices it seems inevitable that intrafamilial reproduction occurred and the resultant levels of inbreeding would have been substantial. Currently, couples related as second cousins or closer (F >or= 0.0156) and their progeny account for an estimated 10.4% of the global population. The highest rates of consanguineous marriage occur in north and sub-Saharan Africa, the Middle East, and west, central, and south Asia. In these regions even couples who regard themselves as unrelated may exhibit high levels of homozygosity, because marriage within clan, tribe, caste, or biraderi boundaries has been a long-established tradition. Mortality in first-cousin progeny is approximately 3.5% higher than in nonconsanguineous offspring, although demographic, social, and economic factors can significantly influence the outcome. Improving socioeconomic conditions and better access to health care will impact the effects of consanguinity, with a shift from infant and childhood mortality to extended morbidity. At the same time, a range of primarily social factors, including urbanization, improved female education, and smaller family sizes indicate that the global prevalence of consanguineous unions will decline. This shift in marriage patterns will initially result in decreased homozygosity, accompanied by a reduction in the expression of recessive single-gene disorders. Although the roles of common and rare gene variants in the etiology of complex disease remain contentious, it would be expected that declining consanguinity would also be reflected in reduced prevalence of complex diseases, especially in population isolates.
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              Abnormal sex ratios in human populations: causes and consequences.

              In the absence of manipulation, both the sex ratio at birth and the population sex ratio are remarkably constant in human populations. Small alterations do occur naturally; for example, a small excess of male births has been reported to occur during and after war. The tradition of son preference, however, has distorted these natural sex ratios in large parts of Asia and North Africa. This son preference is manifest in sex-selective abortion and in discrimination in care practices for girls, both of which lead to higher female mortality. Differential gender mortality has been a documented problem for decades and led to reports in the early 1990s of 100 million "missing women" across the developing world. Since that time, improved health care and conditions for women have resulted in reductions in female mortality, but these advances have now been offset by a huge increase in the use of sex-selective abortion, which became available in the mid-1980s. Largely as a result of this practice, there are now an estimated 80 million missing females in India and China alone. The large cohorts of "surplus" males now reaching adulthood are predominantly of low socioeconomic class, and concerns have been expressed that their lack of marriageability, and consequent marginalization in society, may lead to antisocial behavior and violence, threatening societal stability and security. Measures to reduce sex selection must include strict enforcement of existing legislation, the ensuring of equal rights for women, and public awareness campaigns about the dangers of gender imbalance.
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                Author and article information

                Contributors
                Role: Data curationRole: Formal analysisRole: InvestigationRole: MethodologyRole: Project administrationRole: SoftwareRole: VisualizationRole: Writing – original draftRole: Writing – review & editing
                Role: Data curationRole: Formal analysisRole: InvestigationRole: MethodologyRole: Software
                Role: InvestigationRole: Methodology
                Role: ConceptualizationRole: Funding acquisitionRole: Project administrationRole: ResourcesRole: SoftwareRole: SupervisionRole: ValidationRole: Writing – original draftRole: Writing – review & editing
                Role: Editor
                Journal
                PLoS One
                PLoS One
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                30 November 2020
                2020
                : 15
                : 11
                : e0241610
                Affiliations
                [001]Department of Genetic Engineering and Biotechnology, School of Life Sciences, Shahjalal University of Science and Technology, Sylhet, Bangladesh
                University of Naples Federico II, ITALY
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                [¤a]

                Current address: Department of Medical Genetics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada

                [¤b]

                Current address: Department of Biology, The Catholic University of America, Washington, DC, United States of America

                [¤c]

                Current address: Faculty of Science and Technology, Universiti Sains Islam Malaysia Bandar Baru Nilai, Nilai, Negeri Sembilan, Malaysia

                Author information
                https://orcid.org/0000-0003-3688-5923
                https://orcid.org/0000-0001-6444-0214
                Article
                PONE-D-20-07856
                10.1371/journal.pone.0241610
                7703949
                33253173
                12f094bc-4e06-4f2b-9a9f-2b2f216603af
                © 2020 Anwar et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 19 March 2020
                : 15 September 2020
                Page count
                Figures: 9, Tables: 6, Pages: 24
                Funding
                Funded by: funder-id http://dx.doi.org/10.13039/501100007944, Shahjalal University of Science and Technology;
                Award ID: LS 2017/06
                Award Recipient :
                Funded by: University Grant Commission of Bangladesh (BD)
                Award ID: Med 17/2016
                Award Recipient :
                Funded by: funder-id http://dx.doi.org/10.13039/501100004567, Ministry of Education, Government of the People's Republic of Bangladesh;
                Award ID: LS 16/2017
                Award Recipient :
                MH received funding support from the (i) Research Center, Shahjalal University of Science and Technology, Award: LS 2017/06, URL: https://www.sust.edu/research/sust-research-center, (ii) University Grant Commission of Bangladesh, Award: Med 17/2016, URL: http://www.ugc.gov.bd, and (iii) Bangladesh Bureau of Educational Information & Statistics, Ministry of Education of Bangladesh, Award: LS 2017346 (2017-20), URL: http://gare2.banbeis.gov.bd). The funders had no role in study design, data collection and analysis, decision to publish, or manuscript preparation.
                Categories
                Research Article
                Social Sciences
                Sociology
                Human Families
                Biology and Life Sciences
                Population Biology
                Population Metrics
                Death Rates
                Biology and Life Sciences
                Genetics
                Heredity
                Inbreeding
                People and Places
                Geographical Locations
                Asia
                Bangladesh
                Medicine and Health Sciences
                Medical Conditions
                Congenital Disorders
                Congenital Anomalies
                Biology and Life Sciences
                Genetics
                Human Genetics
                Medicine and Health Sciences
                Public and Occupational Health
                Medicine and Health Sciences
                Pediatrics
                Child Health
                Medicine and Health Sciences
                Public and Occupational Health
                Child Health
                Custom metadata
                All relevant data are within the manuscript and its Supporting Information files.

                Uncategorized
                Uncategorized

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