Factors affecting marriage decisions among couples with sickle cell or beta-thalassemia traits.

Objective: This study assessed the prevalence of marriage among genetically incompatible couples at risk of having children with either sickle cell disease (SCD) or beta-thalassemia (β-thalassemia) in Jazan province, KSA, and the factors influencing these couples' decisions to marry. Methods: An analytical cross-sectional research design was used. From the National Health Premarital Screening System database, couples whose premarital screening tests indicated genetic incompatibility and a risk of having children with either SCD or β-thalassemia were randomly selected, with a sample size of 386 couples. Results: The prevalence of risky marriages that might result in children with SCD or β-thalassemia was 60.4 %. Marriage was more favored among participants who already were married, divorced, or widowed, or who had children during the screening period, than among unmarried participants (P = 0.006). Couples with good knowledge and awareness of the risks of SCD to children's lives decided not to marry (P = 0.001). Furthermore, couples who attended all relevant counseling sessions were more likely to decide not to marry than those who attended only one counseling session (P = 0.001). Despite the positive effects of these counseling sessions, many social, cultural, and religious factors, most prominently religion (70.8 %), influenced these couples' decisions to marry and accept the possibility of having a child with SCD or β-thalassemia. Conclusion: Given the high prevalence of SCD and at-risk marriages in the Jazan region, in vitro fertilization and pre-implantation genetic testing services are recommended.