Small Neil, Kelly Brian, Malawsky Daniel S, Lodh Rajib, Oddie Sam, Wright John
Faculty of Health Studies, University of Bradford, Bradford, England, UK.
Bradford Institute for Health Research, Bradford, UK.
Wellcome Open Res. 2024 Sep 26;9:319. doi: 10.12688/wellcomeopenres.22547.2. eCollection 2024.
Children of consanguineous parents have a higher risk of infant and childhood mortality, morbidity and intellectual and developmental disability.
Using a UK based longitudinal cohort study we quantify differences according to the consanguinity status of children from birth to 10 in mortality, health care usage, two health and three educational outcomes. The cohort comprises 13727 children; 35.7% White British, 43.7% Pakistani heritage, and 20.8% are from other ethnic groups.
Compared to children whose parents were not related children whose parents were first cousins were more likely to die by age 10 (odds ratio 2.81, 95% CI 1.82-4.35) to have higher rates of primary care appointments (incident rate ratio 1.39, 95% CI 1.34-1.45) and more prescriptions (incident rate ratio 1.61, 95% CI 1.50-1.73). Rates of hospital accident and emergency attendance (incident rate ratio 1.21,95% CI 1.12-1.30) and hospital outpatients' appointments (incident rate ratio 2.21,95% CI 1.90-2.56) are higher. Children of first cousins have higher rates of speech/ language development difficulties (odds ratio 1.63, 95% CI 1.36-1.96) and learning difficulties (odds ratio 1.89, 95% CI 1.28-2.81). When they begin school they are less likely to reach phonics standards (odds ratio 0.73, 95% CI 0.63-0.84) and less likely to show a good level of development (odds ratio 0.61, 95% CI 0.54-0.68). At age 10 there are higher numbers with special educational needs from first cousin unions compared to all children whose parents are not blood relations (odds ratio 1.38, 95% CI 1.20-1.58). Effect sizes for consanguinity status are similar in univariable and multivariable models where a range of control variables are added.
There is higher childhood mortality and greater use of health care as well as higher rates of learning difficulties, speech and language development challenges and substantive differences in education outcomes in children whose parents are first cousins.
近亲结婚夫妇的子女在婴儿期和儿童期死亡、发病以及智力和发育残疾方面的风险更高。
我们利用一项基于英国的纵向队列研究，根据儿童的近亲关系状况，对其从出生到10岁期间在死亡率、医疗保健使用情况、两项健康指标和三项教育指标方面的差异进行量化。该队列包括13727名儿童；其中35.7%为英国白人，43.7%有巴基斯坦血统，20.8%来自其他种族群体。
与父母无血缘关系的儿童相比，父母为第一代堂兄妹的儿童在10岁前死亡的可能性更高（优势比2.81，95%置信区间1.82 - 4.35），初级保健预约率更高（发病率比1.39，95%置信区间1.34 - 1.45），处方量更多（发病率比1.61，95%置信区间1.50 - 1.73）。医院急诊就诊率（发病率比1.21，95%置信区间1.12 - 1.30）和医院门诊预约率（发病率比2.21，95%置信区间1.90 - 2.56）也更高。第一代堂兄妹的子女出现言语/语言发育困难的比例更高（优势比1.63，95%置信区间1.36 - 1.96）以及学习困难的比例更高（优势比1.89，95%置信区间1.28 - 2.81）。他们开始上学时，达到自然拼读标准的可能性较小（优势比0.73，95%置信区间0.63 - 0.84），表现出良好发育水平的可能性也较小（优势比0.61，95%置信区间0.54 - 0.68）。10岁时，与父母无血缘关系的所有儿童相比，第一代堂兄妹结合生育的儿童中有特殊教育需求的人数更多（优势比1.38，95%置信区间1.20 - 1.58）。在加入一系列控制变量的单变量和多变量模型中，近亲关系状况的效应大小相似。
父母为第一代堂兄妹的儿童在儿童期死亡率更高，医疗保健使用更多，学习困难、言语和语言发育挑战的发生率更高，并且在教育成果方面存在实质性差异。
