A long-term follow up of premarital counseling in the Israeli Arab population
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ORIGINAL ARTICLE
A long-term follow up of premarital counseling in the Israeli Arab population Joël Zlotogora & Stavit A. Shalev
Received: 10 March 2014 / Accepted: 11 June 2014 / Published online: 29 June 2014 # Springer-Verlag Berlin Heidelberg 2014
Abstract A follow up study of 168 Arab counselees that received premarital genetic counseling between 2001 and 2009, mostly since they planned to marry with a relative, was performed in 2013. Among the 156 cases in which the counselee married, 30 changed their marital plans (19.2 %). Those who changed their marital plans were more often Muslim Arabs that came for counseling since they were related in particular first cousins. Among the 126 counselee that married as planned, 66 were interviewed. From these interviews, it appears that many of the counselees that were related as first cousins or closer came to premarital genetic counseling in order to decide whether to marry. Most of the couples interviewed followed the recommendations concerning the use of folic acid and genetic tests. Among the 53 consanguineous couples interviewed, 49 women had 118 children. Among these 118 children, 8 (6.8 %) were born with a severe disease in 8 different families. This rate of malformations/genetic diseases is similar to the one observed for consanguineous couples from the general Arab population in the region, suggesting therefore that the premarital J. Zlotogora Department of Genetic Community, Public Health Services Ministry of Health, Jerusalem, Israel J. Zlotogora Hebrew University, Jerusalem, Israel S. A. Shalev Genetic Institute, Emek Medical Center, Afula, Israel S. A. Shalev Rappaport Faculty of Medicine, Technion, Haifa [SAS], Israel J. Zlotogora (*) Department of Community Genetics, Building 67 Sheba Medical Center, Ramat Gan, Israel e-mail: [email protected]
counseling and the adherence to the recommendations did not change the final risk to the counselees.
Keywords Premarital genetic counseling . Consanguinity . Arabs
Introduction While consanguineous marriages are relatively frequent in specific populations worldwide (Bittles 2012), there are only few studies assessing the impact and the outcome of voluntary premarital genetic counseling from the counselees perspectives (Hamamy 2012). Several studies about the decisions of couples that received premarital genetic counseling in the context of mandatory screening preventive programs for haemoglobinopathies have been performed (Ahmadnezhad et al 2012; Al-Allawi et al 2013; Alswaidi et al 2012). However, in these studies, the couples were referred to genetic counseling because of the mandatory program and therefore the comparison with couples who request by themselves genetic counseling is not fruitful. A study of couples that came for voluntary premarital counseling because of consanguinity was performed in Israel in the years 1984–1990 based on records of a single genetic clinic (Shiloh et al 1995). Among the 72 consanguineous Jewish couples who received premarital counseling, 52 (72 %) subsequently proceeded with
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