Consanguinity

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One legal definition of degrees of consanguinity. The number next to each box in the table indicates the degree of relationship relative to the given person. Table of Consanguinity showing degrees of relationship.svg
One legal definition of degrees of consanguinity. The number next to each box in the table indicates the degree of relationship relative to the given person.

Consanguinity ("blood relation", from Latin consanguinitas ) is the characteristic of having a kinship with another person (being descended from a common ancestor).

Contents

Many jurisdictions have laws prohibiting people who are related by blood from marrying or having sexual relations with each other. The degree of consanguinity that gives rise to this prohibition varies from place to place. [2] Such rules are also used to determine heirs of an estate according to statutes that govern intestate succession, which also vary from jurisdiction to jurisdiction. [3] In some places and time periods, cousin marriage is allowed or even encouraged; in others, it is taboo, and considered to be incest.

The degree of relative consanguinity can be illustrated with a consanguinity table in which each level of lineal consanguinity ( generation or meiosis ) appears as a row, and individuals with a collaterally consanguineous relationship share the same row. [4] The Knot System is a numerical notation that describes consanguinity using the Ahnentafel numbers of shared ancestors. [5]

Consanguinity of the kings of France as shown in Arbor genealogiae regum Francorum (Bernard Gui, early 14th century). Bernard Gui BNF lat4975.jpg
Consanguinity of the kings of France as shown in Arbor genealogiae regum Francorum (Bernard Gui, early 14th century).

Modern secular law

The degree of kinship between two people may give rise to several legal issues. Some laws prohibit sexual relations between closely-related people, referred to as incestuous. Laws may also bar marriage between closely-related people, which are almost universally prohibited to the second degree of consanguinity.[ citation needed ] Some jurisdictions forbid marriage between first cousins, while others do not. Marriage with aunts and uncles (avunculate marriage) is legal in several countries. [6] [7]

Consanguinity is also relevant to inheritance, particularly with regard to intestate succession. In general, laws tend to favor inheritance by persons closely related to the deceased. Some jurisdictions ban citizens from service on a jury on the basis of consanguinity as well as affinity with persons involved in the case. [8] In many countries, laws prohibiting nepotism ban employment of, or certain kinds of contracts with, the near relations of public officers or employees.[ citation needed ]

Religious and traditional law

Christianity

Under Roman civil law, which the early canon law of the Catholic Church followed, couples were forbidden to marry if they were within four degrees of consanguinity. [9] Around the ninth century the church raised the number of prohibited degrees to seven and changed the method by which they were calculated; instead of the former Roman practice of counting each generational link up to the common ancestor and then down again to the proposed spouse as a single degree, the new method computed consanguinity only by counting back the number of generations to the common ancestor. [9] Intermarriage was now prohibited to anyone more closely related than seventh cousins, which meant that in particular the nobility struggled to find partners to marry, the pool of non-related prospective spouses having become substantially smaller. They had to either defy the church's position or look elsewhere for eligible marriage candidates. [9] In the Roman Catholic Church, unknowingly marrying a closely consanguineous blood relative was grounds for a declaration of nullity, but during the eleventh and twelfth centuries dispensations were granted with increasing frequency due to the thousands of persons encompassed in the prohibition at seven degrees and the hardships this posed for finding potential spouses. [10]

In 1215 the Fourth Lateran Council made what they believed was a necessary change to canon law reducing the number of prohibited degrees of consanguinity from seven back to four, but retaining the later method of calculating degrees. [11] [12] After 1215, the general rule was that fourth cousins could marry without dispensation, greatly reducing the need for dispensations. [10] In fourteenth century England, for example, papal dispensations for annulments due to consanguinity (and affinity) were relatively few. [13]

The ban on marriage to minor degrees of relationship imposed by the Roman Catholic Church was met with heavy criticism in the Croatian society in the 11th century, which led to a schism in the Croatian church. [14]

Among the Christian Habesha highlanders of Ethiopia and Eritrea (the predominantly orthodox Christian Amhara and Tigray-Tigrinya), it is a tradition to be able to recount one's paternal ancestors at least seven generations away starting from early childhood, because "those with a common patrilineal ancestor less than seven generations away are considered 'brother and sister' and may not marry." The rule is less strict on the mother's side, where the limit is about four generations back, but still determined patrilinearly. This rule does not apply to Muslims or other ethnic groups. [15]

Islam

The Quran at 4:22–24 states. "Forbidden to you in marriage are: your mothers, your daughters, your sisters, your father's sisters, your mother's sisters, your brother's daughters, your sister's daughters." [16] Therefore, the list of forbidden marriage partners, as read in the Qur'an, Surah 4:23, does not include first cousins. [17] Muhammad himself married his first cousin Zaynab bint Jahsh. [18] [ better source needed ]

Financial incentives to discourage consanguineous marriages exist in some countries: mandatory premarital screening for inherited blood disorders has existed in the UAE since 2004 and in Qatar since 2009, whereby couples with positive results will not receive their marriage grant. [19]

Hinduism

In the Manusmriti , blood relation marriage (on the mother's side) is prohibited for 7 generations.[ citation needed ]

Ayurveda states that marriage within the Gotra (father's side) is a consanguineous marriage which can lead to many gestational and genetic problems in the fetus. Therefore, it has become a common practice in Hindu households during pre-marriage discussions to ask the couples' Gotra. Couples of the same Gotra are advised not to marry. The advisers of this system say that this practice helps to reduce gestational problems and ensures a healthy progeny.[ citation needed ]

Genetic definitions

Average DNA shared between relatives [20]
RelationshipAverage DNA
shared %
identical twin100%
fraternal twin50%
parent / child50%
sibling50%
half-sibling25%
grandparent / grandchild25%
aunt / uncle / niece / nephew25%
half-aunt / half-uncle / half-niece / half-nephew12.5%
double-first-cousin25%
first-cousin12.5%
half-first-cousin6.25%
great-grandparent / great-grandchild12.5%
grandaunt / granduncle / grandniece / grandnephew12.5%
first-cousin-once-removed6.25%
second-cousin3.125%
A simplistic depiction of genetic relatedness after n generations as a 2 progression. Gene-distribution.png
A simplistic depiction of genetic relatedness after n generations as a 2 progression.
Diagram of common family relationships, where the area of each colored circle is scaled according to the coefficient of relatedness. All relatives of the same relatedness are included together in one of the gray ellipses. Legal degrees of relationship can be found by counting the number of solid-line connections between the self and a relative. Coefficient of relatedness.png
Diagram of common family relationships, where the area of each colored circle is scaled according to the coefficient of relatedness. All relatives of the same relatedness are included together in one of the gray ellipses. Legal degrees of relationship can be found by counting the number of solid-line connections between the self and a relative.

Genetically, consanguinity derives from the reduction in variation due to meiosis that occurs because of the smaller number of near ancestors. Since all humans share between 99.6% and 99.9% of their genome, [21] consanguinity only affects a very small part of the sequence. If two siblings have a child, the child has only two rather than four grandparents. In these circumstances, the probability is increased that the child will inherit two copies of a harmful recessive gene (allele) (rather than only one, which is less likely to have harmful effects).

Genetic consanguinity is expressed as defined 1922 by Wright [22] with the coefficient of relationship r, where r is defined as the fraction of homozygous due to the consanguinity under discussion. Thus, a parent and child pair has a value of r=0.5 (sharing 50% of genes), siblings have a value of r=0.5, a parent's sibling has r=0.25 (25% of genes), and first cousins have r=0.125 (12.5% of genes). These are often expressed in terms of a percentage of shared DNA.

As a working definition, unions contracted between persons biologically related as second cousins or closer (r ≥ 0.03125) are categorized as consanguineous. This arbitrary limit has been chosen because the genetic influence in marriages between couples related to a lesser degree would usually be expected to differ only slightly from that observed in the general population. Globally it is estimated that at least 8.5% of children have consanguineous parents. [23]

In clinical genetics, consanguinity is defined as a union between two individuals who are related as second cousins or closer, with the inbreeding coefficient (F) equal or higher than 0.0156.where (F) represents the proportion of genetic loci at which the child of a consanguineous couple might inherit identical gene copies from both parents. [24]

It is common to identify one's first- and second-degree cousins, and sometimes third-degree cousins. It is seldom possible to identify fourth-degree cousins, since few people can trace their full family tree back more than four generations. (Nor is it considered important, since fourth cousins tend to be genetically no more similar to each other than they are to any other individual from the same region.) [25]

Epidemiology, rates of occurrence

Cultural factors in favor

Reasons favoring consanguinous marriage have been listed as higher compatibility between husband and wife sharing same social relationships, couples stability, enforcing family solidarity, easier financial negotiations and others. [24] :187 Consanguinity is a deeply rooted phenomenon in 20% of the world population, mostly in the Middle East, West Asia and North Africa. [24] Globally, the most common form of consanguineous union is between first cousins, in which the spouses share 18 of their genes inherited from a common ancestor, and so their progeny are homozygous (or more correctly autozygous) at 116 of all loci (r = 0.0625). [26] Due to variation in geographical and ethnic background and the loci chosen to genotype there is some 2.4% variation expected. [27]

Europe

Historically, some European nobles cited a close degree of consanguinity when they required convenient grounds for divorce, especially in contexts where religious doctrine forbade the voluntary dissolution of an unhappy or childless marriage. [28]

Muslim countries

In the Arab world, the practice of marrying relatives is common. According to the Centre for Arabic Genomic Research, between 40% and 54% of UAE nationals' marriages are between family members, up from 39% in the previous generation. Between 21% and 28% of marriages of UAE nationals were between first cousins. [19] [29] Consanguineous marriage is much less prevalent in Christian Arabs as they do not practice arranged marriages. [30] [31] [32] [33] Additionally, an indult dispensation is required to marriages contracted between first cousins or closer in Arab Christian denominations in communion with the Roman Catholic Church, and the Greek Orthodox Church; there are no similar regulations that apply to first-cousin marriages in the Coptic Orthodox Church. [33]

In Egypt, around 40% of the population marry a cousin. A 1992 survey in Jordan found that 32% were married to a first cousin; a further 17.3% were married to more distant relatives. [34] 67% of marriages in Saudi Arabia are between close relatives as are 54% of all marriages in Kuwait, whereas 18% of all Lebanese were between blood relatives. The incidence of consanguinity was 54.3% among Kuwaiti natives and higher among Bedouins. [35]

It has been estimated that 55% of marriages between Pakistani Muslim immigrants in the United Kingdom are between first cousins, [36] where preferential patrilateral parallel cousin marriage, i.e. a boy marrying the daughter of his father's brother is favored.

Double first cousins are descended from two pairs of siblings, and have the same genetic similarity as half-siblings. In unions between double first cousins the highest inbreeding coefficients are reached, with an (F) of 0.125, for example in among Arabs and uncle-niece marriages in South India. [24]

Genetic disorders

The phenomenon of inbreeding increases the level of homozygotes for autosomal genetic disorders and generally leads to a decreased biological fitness of a population known as inbreeding depression, a major objective in clinical studies. [37] While the risks of inbreeding are well-known, informing minority group families with a tradition of endogamy and changing their behavior is a challenging task for genetic counseling in the health care system. [38] The offspring of consanguineous relationships are at greater risk of certain genetic disorders. Autosomal recessive disorders occur in individuals who are homozygous for a particular recessive gene mutation. [39] This means that they carry two copies (alleles) of the same gene. [39] Except in certain rare circumstances (new mutations or uniparental disomy) both parents of an individual with such a disorder will be carriers of the gene. [39] Such carriers are not affected and will not display any signs that they are carriers, and so may be unaware that they carry the mutated gene. As relatives share a proportion of their genes, it is much more likely that related parents will be carriers of an autosomal recessive gene, and therefore their children are at a higher risk of an autosomal recessive disorder. [40] The extent to which the risk increases depends on the degree of genetic relationship between the parents; so the risk is greater in mating relationships where the parents are close relatives, but for relationships between more distant relatives, such as second cousins, the risk is lower (although still greater than the general population). [41]

Consanguinity in a population increases its susceptibility to infectious pathogens such as tuberculosis and hepatitis but may decrease its susceptibility to malaria and other pathogens. [42]

See also

Related Research Articles

Incest is human sexual activity between family members or close relatives. This typically includes sexual activity between people in consanguinity, and sometimes those related by affinity, adoption, or lineage.

Inbreeding Reproduction by closely related organisms

Inbreeding is the production of offspring from the mating or breeding of individuals or organisms that are closely related genetically. By analogy, the term is used in human reproduction, but more commonly refers to the genetic disorders and other consequences that may arise from expression of deleterious or recessive traits resulting from incestuous sexual relationships and consanguinity. Animals avoid incest only rarely.

An incest taboo is any cultural rule or norm that prohibits sexual relations between certain members of the same family, mainly between individuals related by blood. All human cultures have norms that exclude certain close relatives from those considered suitable or permissible sexual or marriage partners, making such relationships taboo. However, different norms exist among cultures as to which blood relations are permissible as sexual partners and which are not. Sexual relations between related persons which are subject to the taboo are called incestuous relationships.

Exogamy is the social norm of marrying outside one's social group. The group defines the scope and extent of exogamy, and the rules and enforcement mechanisms that ensure its continuity. One form of exogamy is dual exogamy, in which two groups continually intermarry with each other.

The coefficient of relationship is a measure of the degree of consanguinity between two individuals. The term coefficient of relationship was defined by Sewall Wright in 1922, and was derived from his definition of the coefficient of inbreeding of 1921. The measure is most commonly used in genetics and genealogy. A coefficient of inbreeding can be calculated for an individual, and is typically one-half the coefficient of relationship between the parents.

In genealogy, pedigree collapse describes how reproduction between two individuals who share an ancestor causes the number of distinct ancestors in the family tree of their offspring to be smaller than it could otherwise be. Robert C. Gunderson coined the term; synonyms include implex and the German Ahnenschwund.

In Catholic canon law, affinity is an impediment to marriage of a couple due to the relationship which either party has as a result of a kinship relationship created by another marriage or as a result of extramarital intercourse. The relationships that give rise to the impediment have varied over time. Marriages and sexual relations between people in an affinity relationship are regarded as incest.

<span class="mw-page-title-main">Cousin</span> Descendant of an ancestors sibling

Most generally, in the lineal kinship system used in the English-speaking world, a cousin is a type of familial relationship in which two relatives are two or more familial generations away from their most recent common ancestor. Commonly, "cousin" refers to a first cousin – a relative of the same generation whose most recent common ancestor with the subject is a grandparent.

Inbreeding depression is the reduced biological fitness which has the potential to result from inbreeding. Biological fitness refers to an organism's ability to survive and perpetuate its genetic material. Inbreeding depression is often the result of a population bottleneck. In general, the higher the genetic variation or gene pool within a breeding population, the less likely it is to suffer from inbreeding depression, though inbreeding and outbreeding depression can simultaneously occur.

In law and in cultural anthropology, affinity is the kinship relationship created or that exists between two people as a result of someone's marriage. It is the relationship which each party to a marriage has to the relations of the other partner to the marriage, but it does not cover the marital relationship itself. Laws, traditions and customs relating to affinity vary considerably, sometimes ceasing with the death of one of the marriage partners through whom affinity is traced, and sometimes with the divorce of the marriage partners. In addition to kinship by marriage, "affinity" can sometimes also include kinship by adoption or a step relationship.

3-Methylglutaconic aciduria Medical condition

3-Methylglutaconic aciduria (MGA) is any of at least five metabolic disorders that impair the body's ability to make energy in the mitochondria. As a result of this impairment, 3-methylglutaconic acid and 3-methylglutaric acid build up and can be detected in the urine.

A cousin marriage is a marriage where the spouses are cousins. The practice was common in earlier times, and continues to be common in some societies today, though in some jurisdictions such marriages are prohibited. Worldwide, more than 10% of marriages are between first or second cousins. Cousin marriage is an important topic in anthropology and alliance theory.

Out-crossing or out-breeding is the technique of crossing between different breeds. This is the practice of introducing distantly related genetic material into a breeding line, thereby increasing genetic diversity.

In law, a prohibited degree of kinship refers to a degree of consanguinity and sometimes affinity between persons that results in certain actions between them being illegal. Two major examples of prohibited degrees are found in incest and nepotism. Incest refers to sexual relations and marriage between closely related individuals; nepotism is the preference of blood-relations in the distribution of a rank or office.

Pseudodominance is the situation in which the inheritance of a recessive trait mimics a dominant pattern.

Laws regarding incest vary considerably between jurisdictions, and depend on the type of sexual activity and the nature of the family relationship of the parties involved, as well as the age and sex of the parties. Besides legal prohibitions, at least some forms of incest are also socially taboo or frowned upon in most cultures around the world.

The medical genetics of Jews have been studied to identify and prevent some rare genetic diseases that, while still rare, are more common than average among people of Jewish descent. There are several autosomal recessive genetic disorders that are more common than average in ethnically Jewish populations, particularly Ashkenazi Jews. This is due to population bottlenecks that occurred relatively recently in the past as well as a practice of consanguineous marriage. These two phenomena lead to a decrease in genetic diversity and a higher likelihood that two parents will carry a mutation in the same gene and pass on both mutations to a child.

Cousin marriage in the Middle East Marriage between cousins in Middle Eastern countries

Cousin marriage, or consanguinity, is allowed and often encouraged throughout the Middle East, and in other Muslim countries worldwide such as Pakistan. As of 2003, an average of 45% of married couples were related in the Arab world. While consanguinity is not unique to the Arab or Islamic world, Arab countries have had "some of the highest rates of consanguineous marriages in the world". The bint 'amm marriage, or marriage with one's father's brother's daughter is especially common, especially in tribal and traditional Muslim communities, where men and women seldom meet potential spouses outside the extended family. Anthropologists have debated the significance of the practice; some view it as the defining feature of the Middle Eastern kinship system while others note that overall rates of cousin marriage have varied sharply between different Middle Eastern communities. In pre-modern times rates of cousin marriage were seldom recorded. In recent times, geneticists have warned that the tradition of cousin marriage over centuries has led to recessive genetic disorders.

Consanguine marriage is marriage between individuals who are closely related. Though it may involve incest, it implies more than the sexual nature of incest. In a clinical sense, marriage between two family members who are second cousins or closer qualifies as consanguineous marriage. This is based on the gene copies their offspring may receive. Though these unions are still prevalent in some communities, as seen across the Greater Middle East region, many other populations have seen a great decline in intra-family marriages.

Nagwa Abdel Meguid is an Egyptian geneticist and 2002 winner of the L’Oreal UNESCO Award for Women in Science for Africa and the Middle East. Her research has "identified several genetic mutations that cause common syndromes such as the fragile X syndrome and Autism".

References

  1. "19 Texas Administrative Code §100.1113". texreg.sos.state.tx.us. State of Texas. Retrieved 5 May 2022. Many other US states have the same definition.
  2. O'Sullivan, Kathryn (2019). "Access to marriage: consanguinity and affinity prohibitions in national and international context". Irish Journal of Family Law. 22 (2): 8–12.
  3. Ritchie, Herbert (1940). "Methods of Intestate Succession". University of Cincinnati Law Review. 14: 508.
  4. "Table of Consanguinity". Sleepy Hollow Cemetery.
  5. Højrup, Knud, "The Knot System: A Numeric Notation of Relationship", National Genealogical Society Quarterly, Vol. 84, Numb. 2, p. 115, June 1996, ISSN 0027-934X.
  6. "RCW 26.04.020: Prohibited marriages". app.leg.wa.gov. Retrieved 2021-10-01.
  7. Farrow, Michael G.; Juberg, Richard C. (1969-07-28). "Genetics and Laws Prohibiting Marriage in the United States". JAMA. 209 (4): 534–538. doi:10.1001/jama.1969.03160170030006. ISSN   0098-7484. PMID   5819418.
  8. Ohio, for example, bars from juries in civil cases persons within the fourth degree of consanguinity to either party or their counsel (Ohio Revised Code §2313.17 (2012)); and persons within the fifth degree of consanguinity "to the person alleged to be injured or attempted to be injured by the offense charged, or to the person on whose complaint the prosecution was instituted, or to the defendant". Ohio Revised Code §2945.25 (1981).
  9. 1 2 3 Constance Brittain Bouchard (24 November 2010). Those of My Blood: Creating Noble Families in Medieval Francia. University of Pennsylvania Press. p. 40. ISBN   978-0-8122-0140-6.
  10. 1 2 James A. Brundage (15 February 2009). Law, Sex, and Christian Society in Medieval Europe. University of Chicago Press. p. 356. ISBN   978-0-226-07789-5.
  11. "Fourth Lateran Council: Canon 50. Prohibition of marriage is now perpetually restricted to the fourth degree". 1215. Archived from the original on 2016-08-20.
  12. John W. Baldwin (28 May 1994). The Language of Sex: Five Voices from Northern France Around 1200. University of Chicago Press. p. 78. ISBN   978-0-226-03613-7.
  13. R. H. Helmholz (26 March 2007). Marriage Litigation in Medieval England. Cambridge University Press. p. 86. ISBN   978-0-521-03562-0.
  14. Dvornik, Francis (1970). Byzantine mission among the Slavs. Rutgers University Press. p. 241. ISBN   0813506131.
  15. Wolbert Smidt, "Genealogy" in Siegbert Uhlig, ed., Encyclopaedia Aethiopica: D-Ha, (Wiesbaden: Harrassowitz Verlag, 2005), p. 743.
  16. "Surah An-Nisa [4:22–25]". Quran.com. Retrieved 16 June 2018.
  17. "The Qur'an". Quran Surah An-Nisaa ( Verse 23 )
  18. "Islam's Women". unknown. n.d.
  19. 1 2 Consanguineous marriage: Should it be discouraged? June 2012, MiddleEastHealthMag.com, retrieved 28 Nov 2018
  20. "Average percent DNA shared between relatives". 23andme. Retrieved 2018-05-06.
  21. Jorde, Lynn B; Wooding, Stephen P (2004). "Genetic variation, classification and 'race'". Nature Genetics. 36 (11s): S28–S33. doi: 10.1038/ng1435 . PMID   15508000.
  22. Wright, Sewall (1922). "Coefficients of inbreeding and relationship". American Naturalist . 56 (645): 330–338. doi:10.1086/279872. S2CID   83865141.
  23. Darr, Aamra (14 October 2010). "Consanguineous Marriage and Inherited Disorders" (PDF). University of Bradford: City of Bradford. Retrieved 31 August 2016.
  24. 1 2 3 4 Hamamy, H. (2011). "Consanguineous marriages: Preconception consultation in primary health care settings". Journal of Community Genetics. 3 (3): 185–192. doi:10.1007/s12687-011-0072-y. PMC   3419292 . PMID   22109912.
  25. "Ask a Geneticist" – Understanding Genetics: Human Health and the Genome, Dr. Erin Cline Davis, 23andMe. Edited by Dr. DB Starr, Stanford University (10 October 2008)
  26. Bittles, A H (2001). "A Background Summary of Consanguineous Marriage" (PDF). Centre for Human Genetics Edith Cowan University, Perth, Australia. Retrieved 31 August 2016.
  27. Rehder; et al. (2013). "Documenting suspected consanguinity guidelines". Genet Med. 15 (2): 150–152. doi: 10.1038/gim.2012.169 . PMID   23328890.
  28. James A. Brundage, Law, Sex, and Christian Society in Medieval Europe (Chicago: University of Chicago Press, 1995), p. 193
  29. Bener A, Dafeeah EE, Samson N (2012). "Does consanguinity increase the risk of schizophrenia? Study based on primary health care centre visits". Ment Health Fam Med. 9 (4): 241–8. PMC   3721918 . PMID   24294299.
  30. Tadmouri, Ghazi O; Nair, Pratibha; Obeid, Tasneem; Al Ali, Mahmoud T; Al Khaja, Najib; Hamamy, Hanan A (2009-10-08). "Consanguinity and reproductive health among Arabs". Reproductive Health. 6: 17. doi:10.1186/1742-4755-6-17. ISSN   1742-4755. PMC   2765422 . PMID   19811666.
  31. Vardi-Saliternik, R.; Friedlander, Y.; Cohen, T. (Summer 2002). "Consanguinity in a population sample of Israeli Muslim Arabs, Christian Arabs and Druze". Annals of Human Biology. 29 (4): 422–431. doi:10.1080/03014460110100928. ISSN   0301-4460. PMID   12160475. S2CID   28335793.
  32. Freundlich, E.; Hino, N. (November 1984). "Consanguineous marriage among rural Arabs in Israel". Israel Journal of Medical Sciences. 20 (11): 1035–1038. ISSN   0021-2180. PMID   6511329.
  33. 1 2 Bittles, Alan H.; Hamamy, Hanan A. (2010), Teebi, Ahmad S. (ed.), "Endogamy and Consanguineous Marriage in Arab Populations", Genetic Disorders Among Arab Populations, Springer Berlin Heidelberg, pp. 85–108, doi:10.1007/978-3-642-05080-0_4, ISBN   9783642050800
  34. Consanguineous marriage: Keeping it in the family. Economist, 27 February 2016.
  35. Keith Garbutt Inbreeding and genetic disorder among Arab population. WVU unpublished Paper
  36. "Marriage between cousins increases risks to children". medicinechest.co.uk. n.d. Archived from the original on 14 April 2019. Retrieved 28 November 2018.
  37. Fareed M, Afzal M (2014). "Evidence of inbreeding depression on height, weight, and body mass index: a population-based child cohort study". Am. J. Hum. Biol. 26 (6): 784–95. doi:10.1002/ajhb.22599. PMID   25130378. S2CID   6086127.
  38. Staal, J (2017). "Applied Cultural and Social Studies are Needed for a Sustainable Reduction of Genetic Disease Incidence". European Journal of Sociology and Anthropology. 2 (1): 1–10. doi: 10.20897/ejsa.201701 .
  39. 1 2 3 William J Marshall, Ph. D.; S K Bangert, Clinical biochemistry : metabolic and clinical aspects (Edinburgh; New York: Churchill Livingstone/Elsevier, 2008), p. 920
  40. Benjamin Pierce, Genetics: A Conceptual Approach (New York: W.H. Freeman, 2012), p. 138
  41. Kingston H M, "ABC of Clinical Genetics", 3rd Edition (London: BMJ Books, 2002), Page 7, ISBN   0-7279-1627-0
  42. Lyons EJ, Frodsham AJ, Zhang L, Hill AV, Amos W (2009). "Consanguinity and susceptibility to infectious diseases in humans". Biol Lett. 5 (4): 574–6. doi:10.1098/rsbl.2009.0133. PMC   2684220 . PMID   19324620.