Infant death and consanguineous marriage

EDITOR, - Perinatal mortality and infant mortality are important indicators of community health Consanguineous marriage increases the risk of having children with autosomal recessive disorders and may be a cause of perinatal and infant death that cannot be prevented.^1,2 We recently compared perinatal and infant mortality in children with a Norwegian background and children with a Pakistani background.3

Perinatal mortality in the Pakistani children was 1.5 times higher than that in the Norwegian children, and infant mortality in the Pakistani children was more than double that in the Norwegian children. Deaths due to autosomal recessive disorders were 18 times more common in the Pakistani children. Similarly, deaths due to multiple malformations, which may be part of unrecognised autosomal recessive syndromes, were 10 times more common.

When children who had died of disorders with monogenic inheritance or of congenital malformations were excluded from our series the difference in perinatal mortality between the two groups disappeared and the difference in infant mortality was greatly reduced. The similar perinatal mortality in the two groups may reflect equivalent prenatal and perinatal care in the Pakistani and Norwegian families.

Consanguinity in immigrant populations has great social and cultural advantages but health workers must be well educated about the risks associated with consanguineous marriage. An increase in the rate of consanguineous marriage in immigrant populations has been reported.4 This may lead to an increase in perinatal and infant mortality, which may outweigh the effect of improving prenatal and perinatal care.