Consanguineous marriages in Pakistan.

Data were collected on the occurrence of marriages between close relatives, including cousins, as well as between nonrelatives from 6611 ever married women as part of the 1990-91 Pakistan Demographic and Health Survey (PDHS). The patterns of age at marriage, fertility, child mortality, and urban and rural residence would help authenticate the hypothesis that genetic risks to child health are higher among children of parents closely related. The PDHS indicated that more than half of ever married women aged 15-49 were married to their first cousins. The inclusion of second cousins raised the percentage of consanguineous marriages from 50.3 to 61.2. Another 1.3% were married to other relations and the rest (over 37%) were married to non-relatives. The PDHS also showed that compared to the women who married at 18 years of age, the percentage of those who were married to first cousins was slightly lower among those married at older ages. Distinct urban-rural differentials emerged. In the urban areas the marriages to cousins amounted to 51.3% and 53.1% when other relatives were also counted. In contrast, 65.6% and 66.9%, respectively, were the figures in rural areas. First cousin marriages were higher in the provinces of Baluchistan and Punjab (53% and 54.4%, respectively) than those in Sindh (49.7%) and the North-West Frontier Province (38.8%). Among females the educational status was important with respect to marriages to first cousins: 52.2% had no education, 48.9% had primary education, 43.1% had middle level education, and 32.5% had secondary education. The mean age at marriage of women where the spouse was the cousin was less than when they were married to others. The PDHS demonstrated that only 1.3% of ever married women aged 15-49 were divorced or separated. In addition, child mortality was higher for women married to cousins than those married to others. Child morbidity was also somewhat higher among these marriages, except for those living in urban areas, where the reverse was true. This peculiarity requires further study of the problem of consanguinity.