Genetic Counseling in Southern Iran: Consanguinity and Reason for Referral

Abstract

Population based genetic counseling that promotes public health goals is an appropriate health care service. The genetic counseling center in Shiraz, southern Iran serves most of the clients in the region. During a 4-year period, 2,686 couples presented for genetic counseling. Data files revealed that 85% had consanguineous relationships (1.5% double first cousin, 74% first cousin, 8% second cousin, 1.5% beyond second cousin). Most prevalent reasons for referral were premarital counseling (80%), with 89% consanguinity, followed by preconception (12%), postnatal (7%), and prenatal counseling (1%). The most common abnormalities in probands or relatives were intellectual and developmental disabilities, hearing loss/impairment, and neuromuscular dystrophies. Family history of medical problem(s) and/or consanguinity was the main indication for referral in nearly every family. Premarital consanguinity poses unique challenges and opportunities. There is considerable opportunity for genetic counseling and education for couples in this population. The tradition of consanguinity, which is likely to persist in Iran, requires multidisciplinary agreement regarding the appropriate process of genetic counseling. Effective genetic counseling in Iran hinges on inclusion of data from genetic counseling services in national genomic and epidemiologic research programs.

Genetic Counseling and Genetic Tests Ethical Challenges

“…Also, this type of marriage cause more cases of autosomal recessive disorders in children. The probability of congenital complications is almost 2.5 times higher for children of first cousins compared to parents who are not related [3].…”

“…The National Society of Genetic Counselors has defined genetic counseling as a process in aiding people to comprehend and adapt to the medical, psychological and familial implications of genetic contribution to diseases [3].…”

“…Data indicated that 85% of these couples had consanguineous relationships [3]. The most popular reasons for genetic counseling were premarital counseling (80%), consanguinity (89%), preconception (12%), postnatal (7%) and prenatal counseling (1%).…”

“…It is also a common cultural practice in some countries around the world such as Iran. Public health policies must consider consanguinity as one of its most important criteria [3,4].…”

“…Public comprehension on genetic disorders related to consanguineous marriages must increase via media, physicians, scholars, nursing staff and society leaders [3,4].…”