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[quote][purple]salam. Thank you for the referral hafiz sb. actually there has been a lot of hype about this topic. cousin marriages per se do not always increase the risk of chromosomal or genetic disorders. there are lots of other factors which play a part e.g. family hx of such anomalies already running in the generation, mother's age, father's health etc. see below for details & the link:[/purple] [size=4][blue]Statement on cousins who marry[/blue][/size=4] There has been much debate in the media recently about the practice of cousin marriage and its impact on public health and resources. This statement seeks to set out accurately the risks related specifically to recessive genetic disorders which can arise in cousin marriages. Cousin marriage is a preferred and sustained practice in many parts of the world and there are members of some communities who believe that it has significant social, economic and community benefits. However, there is a potential health risk arising from recessive genetic disorders but this risk is often misrepresented, or can seem overly significant. One recent media report estimated that British Pakistanis were 13 times more likely to have children with genetic disorders than the general population. [green]Taken out of context, this figure implies that ALL British Pakistanis are equally at risk irrespective of marriage patterns, and fails to clarify that the risk relates specifically to recessive genetic disorders which can arise in cousin marriages. [/green] Other types of genetic conditions, including chromosomal abnormalities, sex-linked conditions and autosomal dominant conditions are not influenced by cousin marriage. The absolute risk to first cousins having a child with a recessive genetic condition is about three in every 100 births, unless they have a family history of an autosomal recessive disorder, in which case the risk may be higher. When we also include the background risk of having a child with any type of congenital or genetic disorder, which applies in every pregnancy, the overall risk to first cousins rises to about six in every 100 births, i.e. double the risk in the general population. The great majority of pregnancies do not result in abnormalities. . In order to further contextualise this risk, the Genetic Interest Group (GIG) have made a useful comparison with another risk factor during pregnancy: increased maternal age. According to GIG, the effect of increased maternal age on the rate of Down syndrome, a specific type of chromosomal abnormality, can be compared with the increased risk posed by consanguinity. At 35 years of age, the risk of Down syndrome is four times that at age 25 and increases 15 times by the age of 40. The absolute risk at 40 years is one in every 100 births. There are clear similarities between cousin marriage and increased maternal age. Both represent complex cultural trends. Both however, also carry a biological risk. The key difference, GIG argue, is that cousin marriage is more common amongst a British minority population, whilst increased maternal age is more prevalent within the general population. The NHS has responded to the risk of Down syndrome in cases of increased maternal age by committing significant resources to help address the problem. The national Down syndrome screening programme ensures that all pregnant women are routinely offered a screening test to identify those at increased risk of having a baby with this chromosomal abnormality. Overall, healthcare provision for women having children later in life has improved in order to reflect the cultural trend towards this. In a similar way, it is appropriate to offer genetic counselling to couples whose relationship is consanguineous, preferably before they conceive, in order to establish the precise risk of a genetic abnormality in their children, and to identify if any specific tests may be indicated. Whilst we recognise that in a complex multiethnic society, it is not easy for the NHS to respond to the needs of all, the HGC agrees with GIG’s assertion that, for communities where cousin marriage is the tradition, a similar response to that given to increased maternal age would be appropriate. We would therefore like to see the proper provision of education and information about marriage within a kin-ship group. This should entail access to counselling and support, preferably in the individual’s or couples’ preferred language, and a no-blame approach that enables at-risk couples to come forward for testing. If you are interested in this debate, you might like to visit the following web pages for further information: www.gig.org.uk – this link is for the Genetic Interest Group (GIG), a national alliance of patient organisations with a membership of over 130 charities which support children, families and individuals affected by genetic disorders. www.wellcome.ac.uk The Wellcome Trust is an independent charity funding research to improve human and animal health. Established in 1936 and with an endowment of around £11 billion, it is the UK's largest non-governmental source of funds for biomedical research. If you would like specific advice, you should consult a clinical geneticist or genetic counsellor in your local NHS Regional Genetics Centre. To find out where that is, please contact the British Society of Human Genetics (www.bshg.org.uk) on telephone number - 0121 627 2634. http://www.hgc.gov.uk/client/Content.asp?ContentId=741[/quote]
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