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Consanguineous marriages (Cousin marriages) have been very common since the early existence of humanity. According to a rough estimate, nearly one billion (20%) of the global population live in communities with a preference for consanguineous marriages, predominantly in Muslim countries of the Middle East, Africa, and South Asia.
With 65%, Pakistan has one of the highest rates of cousin marriages globally, followed by India (55%), Saudi Arabia (50%), Afghanistan (40%), Iran (30%), Egypt, and Turkey (20%).
Pakistan, a multi-cultural country with diverse caste systems, has been shown consistently the highest prevalence of consanguinity. Consanguineous marriages are encouraged in the country due to multiple reasons, e.g. to strengthen interfamily ties between close family members, a preference to the same caste and status, fear of incompatibility or difficulty in finding the right partner outside the family, security of being familiar with spouse and in-laws before marriage, restriction for socialization with the opposite gender, and financial constraints especially for dowry. However, various socio-cultural and health-related implications have been identified for consanguineous couples. Owing to shared alleles, consanguinity may lead to genetic disorders, poor pregnancy outcomes, or multiple reproductive and fertility consequences, having adverse effects on mothers, their children, family, and society as a whole.
