To think this is a weird question for a doctor to ask

[ReallyDoc]

Took my DS to A&E today. He had a seizure. Second one he's had. They say nothing to worry about as its febrile seizure and related to him having a high temp and he shluld grow out of them. When DS woke up he was very sleepy I mean he's three and just had a seizure so..he was very quiet.

Anyway the A&E doctor asked a bunch of questions and then discharged us happy DS is fine. One of these questions was "are you and DP (e.g. DS dad) related by blood?". I was like "good god of course not" and he laughed a bit and it was all fine

But now I can't sleep analysing why he asked that. Does he think there looks like there is something genetically off with my kid? What the hell is he suggesting? Or is this a normal question to ask???

You get asked that at your booking appointment with the midwife too - I think it’s more common than people think.

It's a standard question. I read a lot of medical reports and always see 'parents are Non consanguineous'.

I once taught two seven year old best friends (mums were also best friends). The boy and girl were born about a week apart. Turns out they had the same father. I'm pretty sure one of the mums wasn't aware of this

Not incest as such but similar - same year group, two cousins who were also half siblings. Same dad, mums were sisters. They must have literally slept with the same guy one month or so apart.

They asked me when I was pregnant if the baby I was carrying had the same father as my toddler. No background information such as "we ask everyone this question because of the connection with pre-eclampsia". Just an abrupt "has it got the same father as your son". It indeed.

HCP's could forge better relationships and facilitate more help being taken up if they were a little more sensitive and it is likely to cut across all clinical spheres.

From the BMJ article cited upthead.

Aamra Darr, of Leeds University's Centre for Primary Care Research, co-author of that paper, told the BMJ: “Over 20% of humanity come from cultures where consanguineous marriage is common.”

Dr Darr also cited the 1990 Birmingham birth study, which followed 4934 babies, of whom 956 were of Pakistani origin, and found a total rate of genetic disorders of 7.8% among infants of Pakistani origin, compared with 4% among those of European origin. Of the children of Pakistani origin, 68.7% had parents who were blood relatives (Journal of Epidemiology and Community Health 1990;44: 130-5 [PMC free article] [PubMed] [Google Scholar]).

Dr Darr said it was counter-productive to single out a culture and that such an approach risked alienating the Pakistani community. Alluding to a film recently produced by the Heart of Birmingham Primary Care Trust highlighting the dangers of first cousin marriage, which drew criticism from many of the city's Pakistanis, she added: “We know that the risk of Down's syndrome increases with advancing maternal age, but we don't see public education films urging mothers to have children younger.”

Genetic counselling would be a better way to meet the NHS's goal of providing informed choice, she argued. The nature of genetic risk in large extended families meant that “each affected child is an indicator of a cluster at risk.” This simplifies the process of identifying carriers of recessive genes in Pakistani families, she said.

I work with people from a certain area in Asia and most of them aren’t even related just once but multiple times. I was very shocked to discover this. A few families had kids with very bad disabilities including a life limiting one. Mind you, I have no way of knowing if that was just to a poor gene pool or not but the disabilities were unusual and quite severe.

I have thought about this before - particularly when there are men who are prolific "breeders".

A lawyer friend had a particular criminal client who died and she went to the funeral out of respect because she was half way through a case involving him (and he had provided her firm with a considerable income for half a century). The crem was full of "huddled" groups of men (apparently indicative of police officers and prisoners released for the funeral - 2 officers per prisoner) and lots and lots of women and children.

Turned out many of the women were wife, ex-wives, fancy women and their numerous children - all of the first sons from each relationship had the deceased's Christian name (so there was about a dozen "John Smiths") and lots of the first girls had a feminised form of it (Joan, Joanne, Joanna, Jennete, sort of thing). The adults among them, of course, also had families and there was a huge mix of close genetic material (eg his sons had had relationships with his younger girlfriends and also produced children etc) - she said she knew he was something of a Don Juan but had no idea what a complicated situation it was.

Anyway - where families are like that, the chances of unwittingly (or even wittingly) having a child with a close relation must be high.

On an entirely different track, there was also that American fertility clinic doctor who impregnated women with his own sperm rather than using a donor's. At the last count they'd found something like 80-90 children, many of them adults, who had been totally unaware that there were others in the same small town who were there half sibling. One woman said "I'm terrified I may one day find out I have dated my brother".

There's a sort of Calypso song about consanguinity, isn't there?

😄

That's also because the Dad would be a step-parent to your older child.

It is a known factor that step-parents can become a risk to the step child. And abuse / neglect often kicks of in pregnancy.

But some MWs just ask stupid questions off forms without engaging brain - I was asked if my IVF pregnancy was planned!

Is that so? Well I'm from a Scottish island, and the dangers of consanguity have been known for centuries, which is why visiting (deliberate or not) strangers were always welcomed and which is why women tended to move to the mainland to find husbands, sometimes moving back afterwards. Presumably its also why my matrilineal DNA consistenly shows extremely varied results, including non-European. However, in the past I have been labelled "inbred" as a result of coming from an island and being stereotyped due to being white, and not based on fact.

An somewhat aristocratic ex from Surrey OTOH had not one but two cousin-cousin marriages in successive generations.

Maybe switch your reference to "white" people to another race/colour to see how offensive and stereotyping it is.

Consanguity does cause problems, its well known to do so amongst the medical profession and the reasons for it are often cultural and due to lack of education/exercise of human rights. Strangely enough, these also affect white people, albeit to a lesser numerical degree.

Not incest as such but similar - same year group, two cousins who were also half siblings. Same dad, mums were sisters. They must have literally slept with the same guy one month or so apart.

Also to add, this is in an area where a lot of people have lived since they were born, they’re parents were born there too. It’s not an affluent place, many people don’t have the means to move elsewhere. A lot of the children are cousins at the school. And I think many more are related without even realising.

Sounds like you just got a doctor who did a thorough job - it’s a sensible question to ask, don’t think anything of it.

Which culture if you don't mind me asking?

In my maternal family a few generations back we had two sisters who married two brothers and then when respective spouses died the survivors married each other and had further children.

It was one of the more tedious parts to the semi regular family reunions for the elders in the family to say how so and so was a half sibling as well as a first cousin plus a whatever. I can say that my grandmother was somehow and oddly really proud of the fact that they 'kept things in the family'. There were a few intermarriages between cousins that I am aware of (maybe more but I have been no contact with that side for coming onto 30 years).

That was a white British background.

Growing up there was a Traveller camp not far from my house. About seven family units but all related, cousins, aunts, uncles etc. When they grew up they married or had babies with others from the same camp. This had been going on generations. Most of the children and their parents are affected by the small gene pool, unfortunately a lot of the babies are born very sick and don't make it.

Asked at midwife booking and asked at genetic appointment after we had DD (born with a disability) They also had an interpreter automatically at genetic appointment. Had a paediatrician (Pakistani heritage) say that he was used to seeing birth defects in his community but not people like us. Not far from us I understand stat is 75% cousin marriage in a particular community repeated over generations from same small region which can potentially cause serious health issues.

Queen Victoria and Prince Albert were first cousins. One of their sons, Prince Leopold, had haemophilia and it’s generally accepted that the cousin marriage made that more likely.

The Queen and Prince Philip also had a shared ancestry although the relationship was more distant.

My maternal grandmother married her father's first cousin (both White British and middle-class) when my mother was 6 because he was the "only one who would 'have her'" because she was an unmarried mother during the '50s. They had 3 children together - the first died as a newborn, because of a serious birth defect, and the next two were born with heart conditions which weren't picked up on until years later. Consanguine marriages aren't always something for "ethnic minorities", but do tend to throw curveballs into the family tree if children are produced (my aunt, for example, has three sons with serious birth defects probably stemming from the fact that her grandfather and father shared a set of grandparents!).

As a baby/toddler, I had seizures which landed me in hospital, too. I was on epilepsy medication until I was 5, the age when they presumed, back then, that epilepsy is something ALL toddlers grow out of. Well, I didn't. My seizures simply became episodes of absence which weren't picked up on until after my son (now 17) was born. I'm very fortunate in that mine were/are mild... but so many aren't. :Like others, OP, I'd push for your child to be properly investigated. My 17 year old was a few years back following a traumatic brain injury that triggered severe migraine attacks - "just in case". His only complaint, aged 7, was the fact that they "made [him] have a nap at lunchtime like [he was] a baby!"

My aunt and uncle are cousins. Its actually favoured in much of the Arab world.

I had a colleague whose parents were from Pakistan. He was happy to be "introduced" to various young ladies with a view to marriage, but he was very keen to avoid any relatives - "webbed feet! Webbed feet!" he would say... He married a relative of one of his in-laws in the end.

However a (white British) friend's grandparents were possibly first cousins - I say possibly, as the word was that her Grandad was in fact the son of the local lord of the manor.

And as PPs have said my own family tree is riddled with odd marriages, though no consanguinity afaik, more nieces marrying their widowed uncle-by-marriage etc.

The real corker was in a case on bailii recently, where, incidentally to the main case, it was mentioned that a woman had - while still married - married (for immigration fraud?) HER OWN BROTHER. Blimey.

My aunt and uncle are cousins. Its actually favoured in much of the Arab world.

Is there just a lack of awareness of the health implications it can cause? I do struggle to get my head around people doing this so readily and favourable when it causes such difficulties for people in the long run.

Its a fairly normal query in genetics.

Its also NOT unusual, I am from a cluster of small villages where there EVERYONE in the village is pretty much related in some capacity unless they just moved (and most people stick by their roots and dont move).

People finding out they are blood cousins (who didnt grow up as cousins) after dating for a while or having kids is fairly normal.

It’s not illegal to marry your first cousin - whoever you are. Unusual and maybe a bit strange ( or yuk) but not illegal

anyway I had pre eclampsia when I had baby no2. At 3am with a consultant poking at my liver asking if my children had the same father ( they do)
I was a bit surprised that he was asking such a personal question but apparently it makes a difference if they’d had different dads

This was common, in my great grand parents generation I had a great uncle who married a woman and had 2 kids then died so the widow married my other uncle (husbands brother) and had 3 more kids.

Those kids are both half siblings and cousins... it was the done thing back then though, it was a way of keeping everything 'in the family'.

It’s not just the physical disabilities, the IQ drops in children of consanguineous marriages. There has been work done on this subject.