Changes in prevalence and patterns of consanguinity in Bradford, UK  - evidence from two cohort studies.

Background: Research undertaken using the Born in Bradford cohort study identified consanguinity as a major risk factor for congenital anomalies and also reported longer term adverse health outcomes associated with consanguinity. Methods: We report the prevalence of consanguinity from two cohort studies in the same geographical area with a nine year gap: Born in Bradford (BiB) and Born in Bradford's Better Start (BiBBS). We examine and compare rates of consanguinity and the characteristics of the consanguineous in each study population to examine if and how these have changed in the years between the recruitment periods of 2007-2010 (BiB) and 2016-2019 (BiBBS). Results: There had been a substantial decrease in consanguineous unions in women of Pakistani heritage, the proportion of women who were first cousins with the father of their baby fell from 39.3% to 27.0%, and those who were other blood relations fell from 23.1% to 19.3%. Only 37.6% of Pakistani heritage women were unrelated to the father of their baby in BiB, but 53.7% were unrelated in BiBBS. All but one White British respondent was unrelated to their baby's father in both cohorts, and around 90% of the 'Other ethnicities' group (i.e., not White British or Pakistani heritage) were unrelated to the baby's father in both cohorts. The reduction was most marked in women of Pakistani heritage who were born in the UK, in those educated to A level or higher and in women under age 25. Conclusions: An appreciation of changing rates of consanguinity and linked health needs will be valuable to those who commission and provide antenatal, paediatric and genetic services in Bradford and in other areas where consanguinity is likely to be a major risk factor. Falling rates in this city may reflect wider changes in partner choices in similar populations.