Which is the most inbred country in the world?

Consanguinity is termed as wedlock or marriage between close blood relations or biological kin. Consanguineous 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%). The prevalence of consanguineous unions differs amongst countries due to socio-demographic factors, such as geography (urban–rural residential community, isolated area, and population), religion, education, socio-economic status, a familial pattern towards early marriages, or consanguinity between parents. Although the incidence of consanguineous unions somehow decreased with urbanization, modernization, and smaller/nuclear families, however, it is still in practice . 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. A strong association of consanguineous marriages has been reported with increased rates of abortion, stillbirths, pregnancy terminations, low birth weights, increased mortality, and congenital malformations. Furthermore, a low preference for contraception, extended childbearing age, and higher fertility has also been observed in such unions. Although consanguineous marriages are also linked with poor pregnancy outcomes and higher reproductive risks in Pakistan, nonetheless these are also associated with increased fertility rates and larger family size. Consanguineous unions have remained under continuous investigation by social scientists, medical researchers, biologists, and physicians. However, it received less attention in mainstream demographic research. Although multiple studies are available regarding the effects of consanguineous marriages on either reproductive health or fertility behaviors, nevertheless, there is a need to examine and explain the trends of consanguineous marriages and their association with women’s reproductive health and fertility behavior in Pakistan. To our best knowledge, this is the first paper to examine trends in consanguineous marriages in Pakistan in recent decades. Therefore, this research is an attempt to investigate the differentials in reproductive health and fertility behaviors over almost three decades (1990–2018). #Consanguinity #CousinMarriages #FamilyTies #GeneticDisorders #ReproductiveHealth #FertilityBehavior #PakistanMarriages #SocioCulturalImplications #HealthConsequences #GeneticRisk #ReproductiveOutcomes #Urbanization #Modernization #DowrySystem #Socialization #FamilySize #DemographicResearch #MarriageTrends #WomenReproductiveHealth #FertilityPatterns #ResearchPaper #PakistanStudies #ConsanguineousMarriages