Declining consanguinity in the Jhelum population of Pakistan’s Potohar Plateau: Sociodemographic shifts and underlying causes
Consanguineous unions (CUs) have long been a common practice and remain prevalent in many cultures, including those in North Africa, West Asia, the Middle East, and developing countries such as Pakistan. As Pakistan undergoes a demographic transition, characterized by rapid urbanization, declining fertility, rising educational attainment, and a shift toward nuclear families, traditional marriage patterns are evolving. Within this context, this study examines the trends and determinants of marital unions in Jhelum District, located in the Potohar region of Pakistan, to explore how societal change influences consanguinity. Using a cross-sectional design, 1,432 married women were randomly recruited from independent households, and data were collected on marital histories and demographic characteristics. The prevalence of CUs was 56%, with a corresponding inbreeding coefficient of 0.0336. First-cousin unions were the most common, accounting for 45% of all marriages. Multivariable logistic regression identified seven significant predictors of consanguinity: Extended family type, husband’s occupation, wife’s literacy level, caste system, parental consanguinity, reciprocal marriage, and short matrimonial distance. Trend analysis revealed a steady decline in CUs across successive marriage cohorts, particularly after 2010. This decline was observed across all tehsils and was accompanied by an increase in age at marriage. The dynamics of consanguinity and its decline hold important implications for public health, including improved reproductive outcomes, reduced infant and maternal mortality, socioeconomic transition, and long-term population health. Although a gradual nationwide reduction in consanguinity is expected, its pace and magnitude are likely to vary regionally based on cultural norms, socioeconomic development, and rural–urban differences.
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