Consanguinity, pregnancy outcomes and offspring mortality in India: Evidences from National Family Health Survey, 2015-2021

Abstract The authors hypothesize that consanguineous marriages remain a risk factor for pregnancy outcomes and offspring mortality in post-globalized India. Data from women aged 15–49 from National Family Health Surveys 4(2015–2016) and 5(2019–2021) were pooled and used for analysis. The study used binary logistic regression and Cox proportional hazard regression models to examine the effects of close (CC) and distant (DC) consanguinity on spontaneous abortion, stillbirth, neonatal mortality, and post-neonatal, child mortality respectively compared to non-consanguinity (NC). The final model showed that the risk of spontaneous abortion was significantly higher for CC (1.32, p < 0.001) and DC (1.62, p < 0.001); while the likelihood of neonatal mortality was significantly higher for DC (1.30, p < 0.01) compared to NC. The risk of post-neonatal mortality was significantly higher for CC (1.49, p < 0.01) and DC (1.87, p < 0.001) compared to non-consanguineous (NC) marriage. No significant association was found between consanguinity and child mortality. We conclude that the endogenous effect of consanguinity still pose a serious challenge to the survival of fetus and new born; but exogenous effect reduces the risk of child death. We propose to incorporate socially entrenched practice of consanguinity explicitly into Mosley and Chen's (1984) framework for the aid in understanding child survival in developing countries.