ArticlePloS one2026
Survival disparities and competing mortality risks in offspring of consanguineous marriages in Yemen: A 26-year retrospective cohort analysis.
Article in PloS one, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundConsanguineous marriage is prevalent in many global populations and increases the risk of autosomal recessive genetic disorders in offspring. However, long-term disorder-specific survival patterns and competing mortality risks in this population remain poorly quantified, limiting evidence-based prognostic counseling and healthcare planning.
objectiveThis study aimed to determine disorder-specific survival disparities, quantify cause-specific mortality using competing risks analysis, and evaluate the independent effect of the degree of consanguinity on mortality.
methodsWe conducted a 26-year retrospective cohort study (1998-2024) of 3,427 offspring from 1,065 Yemeni families. Vital status and cause of death were ascertained through multi-source verification. Survival analysis employed Kaplan-Meier estimators, Cox proportional hazards models, and Fine-Gray competing risks regression.
resultsFive-year survival varied substantially: 42.3% for hemoglobinopathies, 65.1% for congenital anomalies, 78.2% for neurodevelopmental disorders, and 92.4% for sensory impairments. First-cousin offspring had a 2.8-fold higher adjusted all-cause mortality risk (HR = 2.84, 95% CI 2.32-3.44) than non-consanguineous offspring. Competing-risks analysis revealed distinct age-specific mortality patterns: congenital anomalies dominated infant mortality (cumulative incidence 24.3%), whereas hematological disorders peaked in early childhood (18.7%).
conclusionSurvival in consanguineous offspring shows severe disorder-specific disparities and a strong mortality gradient with the degree of consanguinity. The competing-risks framework provides critical insights for prognostic counseling and for prioritizing early interventions targeting high-risk disorders during critical mortality periods.
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