ArticleScientific reports2025
Consanguineous marriages and low birth weight mediating role of antenatal care visits.
Article in Scientific reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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4 authors.
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Abstract
Low birth weight (LBW) is a critical public health concern in Pakistan, significantly contributing to neonatal mortality and long-term health disparities. Consanguineous marriages, highly prevalent in the region, are associated with adverse birth outcomes. While antenatal care (ANC) visits are crucial for improving maternal and child health, their role in mediating the relationship between consanguinity and LBW remains underexplored. This study investigates whether ANC visits mediate the association between consanguineous marriage and LBW in Pakistan. This cross-sectional study utilized data from the 2017-18 Pakistan Demographic and Health Survey (PDHS), analyzing 14,465 live births. Consanguineous marriage was the independent variable, ANC visits (categorized as ≥ 8 vs. <8) served as the mediating variable, and LBW (< 2500 g vs. ≥2500 g) was the dependent variable. Generalized Structural Equation Modeling (GSEM) with 2000 bootstrap replications was employed to estimate direct and indirect effects, adjusting for maternal age, region, residence, household wealth, and working status. Consanguineous marriage was significantly associated with a reduction in the likelihood of adequate ANC visits (β=-0.015, p < 0.001). ANC visits, in turn, showed a strong and statistically significant negative association with LBW (β=-0.403, p < 0.001). The lmediation analysis revealed a statistically significant indirect effect of consanguineous marriage on LBW through reduced ANC utilization (β = 0.0062, p = 0.001; 95% CI: 0.0026 to 0.0098). A significant direct positive association between consanguineous marriage and LBW also persisted (β = 0.0173, p = 0.035; 95% CI: 0.0012 to 0.0335), confirming a partial mediation effect. Our findings indicate that consanguineous marriage increases the risk of LBW in Pakistan, partially mediated by reduced antenatal care utilization. This suggests that both behavioral (reduced ANC uptake) and potentially biological (genetic) pathways contribute to adverse birth outcomes in consanguineous unions. Targeted interventions are needed to increase ANC access and utilization, particularly in rural and low-income consanguineous communities, alongside promoting women's healthcare autonomy and genetic counseling to mitigate the burden of LBW.
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