Marriage Within Relatives in Nepal | Reasons Why It Is Not Common?

We are here with marriage within relatives in Nepal. Why wedding withing blood relation or family is not common? Can it have some adverse effects?

In Nepal, marriage is considered to be the sacred relation formed with Agni (Fire) as the witness. Usually, marriage is the union of a man and woman stranger to one another.

But there are some casts and culture in Nepal, where union takes place between relatives with one or more ancestors common. Tamangs, Gurungs, Magars accept the marriage with the daughter of a maternal uncle, or father’s sister. They are considered to be not so close relatives. So marriage with their daughter is accepted.

There are degrees of closeness in relatives. Marriage between very close blood relatives such as parents and children. Brothers and sisters etc are those who are morally, medically and legally are prohibited.

Such marriages don’t take place in Nepal, not in any part of the world. However, certain cases exist with exception who blinded. by love and passion get involved in such relationships.

This type of marriage within relatives is also called Consanguineous marriage, Inbred marriage or Endogamy marriage. Those who married to very close blood relatives are called the Incest marriage. Incest marriage doesn’t take place in Nepal.

wedding in Nepal
wedding in Nepal

Definition of Marriage Withing Relatives

Inbreeding is a practice according to which a group of individuals rejects or denies the incorporation of individuals outside the group itself. The word, as such, is composed of the prefix endo which means inside and gamia, which means union.

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Inbreeding is a social behavior or attitude in which members of other groups are prevented from associating or joining. Either for marriage or for reproduction, with members of a particular group.

In this sense, inbred groups usually limit the unions or marriages of their group taking into account factors. Such as: having a common ancestry or lineage, belonging to the same social class. Having the same religion, being part of the same ethnic group, or be natural from the same geographical area.

In the population among all marriages, various types of related marriages are found. To assess the risk of having a child with a hereditary pathology in a family of blood relatives.

It is important to establish what degree of relationship between a pair of spouses and what part of the genes they have in common. In this case, the coefficient of inbreeding is determined. It is defined as the probability that in any individual both genes in a given locus belonged to one of the ancestors in some of the previous generations.

The inbreeding coefficient is the probability that two alleles of the same gene are identical in origin. The higher the degree of kinship of spouses, the greater the coefficient of inbreeding of their descendants. Therefore, the greater the likelihood that both alleles of the same locus are identical. If specific recessive alleles are abnormal.

Endogamy in biology

According to biology and genetics, inbreeding is the cross between individuals of the same race, community or population that is geographically and genetically isolated. In an inbreeding junction, the chances of having offspring affected by recessive traits or genetic deterioration are increased.


Why is the marriage between relatives considered undesirable?

The opinion that the closer the parents are in a kinship, the mentally and physically weaker their offspring, there is not a single decade. This fact is explained by the fact that the probability of meeting the same pathological genes is too high.

Religion as well as medicine, does not recommend marriage with close relatives. Because there is a possibility of the presence of hidden genetic factors within one family. That are those genes that are in sleep mode.

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They can be passed on from generation to generation to descendants without manifesting themselves but can come to light at any time. Thus, it turns out that close relatives are always carriers of the same pathogenic genes – both active and passive.

Consequently, during the marriage within the same family or between relatives, these factors are concentrated within the same family. In the future, these factors affect the offspring, in most cases – in the fetus, and in the future – in the born child.

Recessive diseases occur in families where both parents are carriers of the same harmful gene. The fact is that most known recessive diseases are quite rare. And the coincidence of the carrier of one genetic defect in both spouses is a rare event. But if they marry relatives, the likelihood of such a coincidence increases dramatically.

lovely couple
lovely couple

The explanation is quite simple. After all, blood relatives are relatives who have at least one, often two, and sometimes a greater number of common ancestors.

For example, cousins ​​have the same grandfather and grandmother. And it was already mentioned above that each person is a carrier of at least one or two harmful recessive genes.

Therefore, the pathological gene that grandparents had could well be passed on to both of their grandchildren. Therefore, in this case, will be carriers of the same harmful gene, obtained from a common source.

Therefore, children from such married couples are much more likely to find various recessive diseases. And pregnancies more often end in miscarriages and stillbirths than in unrelated marriages.

On the other hand, in burdened families, there is a clear correlation between the frequency of recessive diseases and consanguineous marriages. The less often the disease occurs in society, the more often the parents of sick children turn out to be blood relatives.

The closer the degree of relationship between spouses, the higher the risk of genetic complications for their offspring.

We are talking about very serious defects: hemophilia, Down syndrome, dementia and other pathologies from the nervous system. If, during the normal marriage, the probability of having a child with serious deviations: Genetic (congenital) defects and Mental retardation is not more than 4%, then in a closely related marriage, the risk increases 5 times. In such a marriage increases compared to unrelated:

  • At 24% the risk of having a dead baby or fetal death;
  • At 34% risk of dying a baby at an early age;
  • At 48% risk of developing malformations of the fetus.

Causes of Consanguineous marriages

In ancient times, inbreeding was very common for several reasons. To maintain power within the same family, to establish alliances with other groups of the same social class, or to maintain the purity of a supposed race.

The reason for any inbred system is to defend the homogeneity of a group. So that it remains always equal to itself and differentiable from all others. Clan unity is the supreme reason.

Some primitive societies (for fleeing the added difficulty of the difference of people and culture. And because they understood that in this way the unity of the tribe was guaranteed and therefore internal peace) resolved that marriages would always have to be between individuals from the same tribe.

The affinity of blood between husband and wife was all the greater the greater the power of the tribe or the caste within it. So, in the case of the dominant caste, marriages were imposed between cousins. Between siblings and in some cultures even between father and daughter, so that the power did not leave the dominant family.

It is a universal phenomenon that occurs for different reasons: preservation of surnames, lineage, economic goods, geographic or social isolation, religious or race conservation. Historically and evolutionarily, it tends to decrease as a result of modernity, the physical movement of individuals and new knowledge.


Medical risks of such marriage withing relation

Marriage is said to be endogamous when the spouses have one or more common ancestors. Marriage with the patrilineal parallel cousin is the first possible form of endogamy. Differences are affirmed between cousins, patrilateral are valued because of the sexual hierarchy.

These differences vary according to the type of marriage carried out by the parents. If the father’s sister has married an agnate. It is certain that his children will maintain links with the siblings based on a strengthened agnatic identity. It will not be the case if she marries outside the agnatic group.

Consanguineous marriages were identified mostly in rural areas and among first cousins. Effects such as infant mortality, rare monogenic diseases, congenital malformations, mild intellectual disability.

And common diseases appeared more frequently in the offspring of sibling cousins. By medical research, coronary heart disease, stroke, cancer, arthritis, bipolar depression. Asthma, peptic ulcer, and osteoporosis and Mental infirmity i.e. low intelligence are also disorders that have been found to be related to inbreeding.

Each of our cells contains 46 chromosomes, which are divided into 23 pairs. In each of these pairs, one chromosome comes from the father, and the other from the mother.

marriage image
Love

Thus, everyone, therefore, has all the genes in duplicate: some of the paternal origins, others of maternal origin. However, many genetic diseases that originate from a defective gene only arise if the latter is present in duplicate, in the copy coming from the father and the mother.

Some common abnormalities and diseases that can be seen in such marriages are:

  1. Sickle Cell Anaemia:

Sickle cell disease is a condition in which red blood cells do not have the form they should have. Red blood cells usually look like rounded discs. But in sickle cell disease, they are shaped like a crescent moon or an ancient tillage tool called a sickle. These sickle-shaped cells stick together easily and clog blood vessels of reduced size.

When blood cannot get where it should go, it can lead to pain and injuries to the organs. Pain can occur anywhere in the body and can be triggered by cold, stress, illness or dehydration. The episodes of pain can be short-lived (lasting only a few hours), lasting several days or even longer. Sometimes pain can be controlled at home.

But people with severe pain may have to be treated in a hospital. People with sickle cell anemia may develop jaundice. This occurs because sickle-shaped red blood cells break down faster than normal red blood cells. Sickle Cell Anaemia is more common in the Tharu people of Nepal.

  1. Coronary Heart Disease:

Coronary heart disease is a heart disease that most often causes chest pain. Coronary artery disease is diagnosed if the coronary artery supplying oxygen to the myocardium is narrowed.

Narrowing, or stenosis, of the coronary artery, leads to myocardial hypoxia, which manifests itself in the form of pain in the chest. As a rule, chest pain caused by heart disease intensifies during exertion, and rest partially eliminates the symptoms.

Coronary Heart Disease
Coronary Heart Disease

The most important risk factors for coronary heart disease are smoking, diabetes, hypertension, high cholesterol, and hereditary burden. By hereditary burden is meant that relatives of the first knee (parents, brothers, and sisters) under the age of 55 years in men.

And up to 65 years in women have a history of myocardial infarction. Or they underwent balloon angioplasty or coronary artery bypass grafting. If the marriage takes place between people who have ancestors suffering from this disease. The probability that the next generation will also have this disease is much higher.

  1. Congenital deafness:

Congenital deafness, in which the child is born without hearing ability. Childhood hearing deficits can lead to permanent changes in receptive and expressive language.

The affectation that deafness produces is greater in children with other sensory, linguistic. Or cognitive deficiencies than in those who are otherwise healthy.

Congenital deafness
Congenital deafness

Most often, a hereditary factor becomes the cause of a congenital malformation of the auditory organs. If one of the direct relatives has hearing problems, then the probability of deafness or hearing loss in a child is from 30 to 50%.

  1. Cystic fibrosis:

Cystic fibrosis, which is an inherited disease in which the glands produce abnormal secretions. That interferes with the digestive and respiratory tract and increases the chance of infections. Cystic fibrosis is the most common among all hereditary diseases.

Due to a gene mutation inherited from both parents. The function of the endocrine glands (sweat glands, intestinal glands, pancreas), as well as the lungs and liver, is impaired.

With this disease, problems occur in almost every organ, but the main symptoms are in the respiratory and digestive systems. The degree of damage to these systems determines the severity of the disease.

  1. Mental Retardation:

Mental retardation is acquired at an early age or congenital psychological underdevelopment caused by organic pathology. The main manifestation of which is intellectual retardation and social disability.

Intellectual disability, which corresponds to the delay in the cognitive and intellectual development of the child. It can be perceived through the difficulty of concentration, learning, and adaptation to different environments. It manifests itself primarily in relation to the mind, and also manifests itself in the sphere of emotions, will, speech and motor skills.

  1. Bone dysplasias:

It is a congenital disease that is characterized because the bones of people who suffer from it break very easily, after minimal trauma and even without apparent cause. The bone matrix contains abnormal collagen fibrils type III and V.

The hydroxyapatite crystals that are deposited in the matrix are not well aligned with respect to the axis of the fibrils. It is due to the insufficient and/or defective formation of the body’s collagen, as a result of a genetic failure. It is characterized by alteration in the development of an organ or tissue. That leads to the deformation of one or more bones, which may result in difficulty in locomotion.

  1. Mucopolysaccharidosis:

Mucopolysaccharidosis is a rare disease in which the body lacks or does not have enough of an enzyme necessary to break down long chains of sugar molecules. As a result, the molecules accumulate in different parts of the body and cause various health problems.

Leading to progressive symptoms related to bones, joints, eyes, heart and nervous system. It is hereditary, which means that your parents have to transmit the disease to you. If both parents carry an inactive copy of the gene related to this condition.

  1. Congenital blindness: –

Congenital blindness, where the child is born without being able to see. It is the one in which the person with the disability is born with it, which occurs due to eye or brain malformation.

For those born with disabilities, acceptance becomes calmer because they have never been able to see. Research involving stem cells proves that this type of cell is great hope for medicine as it can regenerate any tissue in the body. And it was no different from congenital blindness.

  1. Stroke:

A stroke happens when blood circulation to the brain fails. Brain cells can die due to decreased blood flow and lack of resulting oxygen. There are two broad categories of stroke: those caused by a blockage of blood flow and those caused by cerebral hemorrhage.

Blocking a blood vessel in the brain or neck, called an ischemic stroke. It is the most common cause of stroke and is responsible for about 80 percent of strokes. These blockages come from three conditions: the formation of a clot inside a blood vessel in the brain or neck called thrombosis.

The movement of a clot from another part of the body like from the heart to the brain called embolism. Or severe narrowing of an artery inside or going to the brain, called stenosis. Hemorrhage inside the brain or in the surrounding spaces causes the second type of stroke, called a hemorrhagic stroke.

  1. Cancer:

Cancer can originate in any part of the body. It begins when cells grow uncontrollably surpassing normal cells, which makes it difficult for the body to function as it should. For many people, cancer can be treated very effectively.

In fact, now more than ever there is a greater number of people who have a full life after receiving their cancer treatment. Unlike these normal cells, cancer cells continue to grow and divide uncontrollably, and do not die when they should.

Cancer cells usually concentrate or group, forming tumors. A growing tumor becomes a lump of cancer cells that can destroy the normal cells around it and injure healthy body tissues. This can make a person very sick.

  1. Arthritis:

Arthritis is swelling and tenderness of one or more of the joints. The main symptoms of arthritis are pain and stiffness of the joints, which usually get worse with age.

Arthritis
Arthritis

The most frequent types of arthritis are osteoarthritis and rheumatoid arthritis. Some types of arthritis are hereditary, so you are likely to get arthritis if your parents or siblings have this disorder. Your genes can make you more vulnerable to environmental factors that can trigger arthritis.

  1. Peptic Ulcer:

Peptic ulcers are open sores that develop in the inner lining of the stomach and in the upper part of the small intestine. The most frequent symptom of a peptic ulcer is a stomach pain.

  1. Asthma:

It is a chronic disease that affects the airways of human body. The airways are tubular structure that carry air in and out of the lungs. If you have asthma, the inner walls of your airways become inflamed and narrow.

That makes them very sensitive and can react strongly to those things to which you are allergic or find irritants. When the airways react, they narrow and the lungs receive less air.

Asthma
Asthma

For some people, asthma is a minor nuisance. For others, it can be a considerable problem that interferes with everyday activities and can lead to life-threatening asthma attacks.

  1. Nephropathy:

The nephropathy refers to injury, disease or pathology of the kidney. Another older term for it is nephrosis. Chronic renal disease, also called chronic renal failure, describes the gradual loss of renal function.

Your kidneys filter waste and excess fluid from the blood, which is then excreted in the urine. When chronic kidney disease slowly reaches an advanced stage, dangerous levels of body fluids, electrolytes, and wastes can accumulate in your body.

  1. Encephalopathy:

The term encephalopathy means disorder or disease of the brain. In modern use, encephalopathy refers to a syndrome of cerebral dysfunction, which can be caused by multiple etiologies. It can present a wide spectrum of symptoms, ranging from mild.

Such as memory loss or subtle personality changes, to severe, such as dementia, seizures, coma or death. In general, encephalopathy is characterized by an altered mental state. And sometimes also characterized by physical manifestations, for example, poor coordination of limb movements.

  1. Hemophilia:

Hemophilia is a hereditary disease linked to the X chromosome, which means that in the case of hemophilia transmit women (carriers). And men suffer due to the provision of two X chromosomes (XX) of women and an endowment (XY) in man. It is a bleeding disorder where the blood clot is impaired. People who suffer from this disease bleed for a longer period of time.

  1. Down Syndrome:

Down syndrome is not a disease, but a genetic alteration that is produced by the presence of an extra chromosome. The cells of the human body have 46 chromosomes distributed in 23 pairs. People with Down syndrome have three chromosomes in par 21 instead of the two that usually exist. Therefore, it is also known as trisomy 21.

It affects brain and organism development and is the main cause of intellectual disability. And also the most common human genetic alteration. It can also cause medical problems, such as digestive disorders or heart disease.

  1. Dementia:

Dementia is a general term for a serious deterioration of mental ability that interferes with everyday life. Memory loss is an example. Alzheimer’s is the most common type of dementia.

Dementia is often incorrectly referred to as senility or senile dementia, reflecting a widespread. But the incorrect belief that mental impairment is a normal consequence of aging.

  1. Spinal Muscular Atrophy:

Spinal muscular atrophy (SMA) is a genetic disease that attacks nerve cells called motor neurons found in the spinal cord. These neurons communicate with the voluntary muscles, that is, those that you can control, such as those in the arms and legs.

As muscles lose neurons weaken. That can affect your ability to walk, crawl, breathe, swallow and control your head and neck. SMA has a family trend. Parents do not usually have symptoms, but they carry the gene. If the disease exists in your family, genetic counseling is important.

  1. Friedreich’s Ataxia:

Friedreich’s ataxia is a hereditary disease that causes progressive damage to the nervous system. It can cause muscle weakness, speech difficulties or heart disease.  The first symptom is usually difficulty walking. The term ataxia refers to problems of coordination and instability.

It occurs in many different diseases and conditions. In Friedreich’s ataxia, there is degeneration of the nerve tissue of the spinal cord. And nerves that control the movement of the arms and legs.


Other Risks on marriage within relatives

Ignorance or lack of awareness of what can lead to a blood match makes it not uncommon to witness children with metabolic problems, physical and/or mental deformities.

Inbreeding, that is, between relatives, especially parents and children, siblings, first or second cousins, uncles, and nephews, etc.  can cause serious health problems to offspring.

It is something to be considered and highlighted.  But the fact is not as a rule.  It may occur that close relatives are married and the children have no deviations, dysfunctions or diseases.

But the probability is not irrelevant.  Anomalies may occur due to the possibility of recessive genes. Which needs to be double-dose in order for the characteristic to be determined in the individual.

To manifest a recessive trait one must receive the chromosome gene of maternal origin and that of paternal origin.  Therefore the harmful effect of consanguineous marriage is to greatly increase the chances of offspring affected by rare anomalies.

This fact has a genetic, scientific basis.  It is therefore not wise for people in the same family to raise children.  This reality is very explicit when we analyze schools and clinics that perform multidisciplinary diagnoses.

The number of children born to relatives is large. In practice, it is observed that the fact occurs in the most varied social classes.

There is a lack of educational campaigns to raise awareness of the possible consequences of this kind of union.  One must always be reminding people of the degree of difficulty that can happen.

There are those who know there are risks but do not really know the possible problems. And do not consider the fact as they should.  Passion, desires, involvement all surpass the notion of danger.

In the past, consanguineous marriages existed so that material goods would not be shared among other families.  Children are big victims of this kind of problem, and the consequences for their parents are also very difficult.  Challenges arise, blames and the situation is not easy.

If this happens, it is necessary that the attitude is to face the problem, with the necessary professional support. But prevention, obviously, is the most important.  Nature encourages genetic mixing because, on the contrary, the likelihood of pathologies is present.  There to be mixtures between families.

There are several educational campaigns on other topics conducted by the Ministry of Health. It should alert to this real demand to lead populations to reflect on blood relations that are more common than we can imagine.


Famous People involved in Inbred Marriage

History has shown us that especially rulers and novelties were more involved in inbred and incest marriage. Some of the famous people who were involved in such marriages were Cleopatra.

It is said that her parents were brother and sister. Later she also married her brother. Another one is John Philips who got involved with his own daughter. These are the example of the closest or first-degree incest marriage. Some.of other personalities who were in inbred marriage are:

  1. Tutankhamen:

It is no secret to anyone that the ancient Egyptian kings kept things in family with the aim of guaranteeing the purity of their lineage. And with the famous Tutankhamun things were not different.  A thorough study of the body of the young pharaoh revealed a whole series of data about his past.

King Tutankhamen
King Tutankhamen

The remains of Tutankhamen underwent a virtual autopsy with more than two thousand computerized scans. That pointed to having crooked teeth and hips with feminine features.  The exams also offered evidence about temporal lobe epilepsy and Kohler disease, a painful foot problem that surely made him limp.

In addition, genetic analysis showed that Tutankhamun’s parents were siblings. A fact that not only could he have contributed to the various health problems he presented but was also key in his premature death.

In addition to having been the product of incestuous marriage, King Tut married his half-sister, Anjesenamon – who became pregnant twice.

  1. Charles Darwin:

The story is more curious than shocking and has to do with British naturalist Charles Darwin. He is famous for his contributions to the theory of evolution, who married Emma Wedgwood Darwin, his first-grade cousin. The couple had ten children of which three died at a very young age and three others were sterile.

Charles Darwin
Charles Darwin

In the case of Charles Darwin, it was to be expected that the man would keep detailed records of his family’s health. When his children presented problems, the naturalist would associate them with his observations made previously on plants that had been crossed with each other.

It was then that Darwin began to suspect that his children may have inherited illnesses due to their family history of marriages between relatives.

Later, a group of researchers analyzed four family generations of Darwin. And Wedgwood discovering that many members of both parties had married each other. As the naturalist himself suspected, the health problems of their children were the result of that genetic inheritance.

  1. Habsburg dynasty:

Over several centuries, the House of Habsburg, of Austria, was the dominant royal dynasty in Europe. In addition to the fact that its members remained on the Austrian throne for more than six centuries. Strategic marriages allowed their power to expand to the courts of Hungary, Bohemia, and Spain.

Habsburg dynasty
Habsburg dynasty

However, the problem was that at some point there were no more European nobles. And monarchs who were not from the House of Habsburg – a fact that gave rise to a long list of incestuous marriages.

So much so that the historical records indicate that during the reign of this dynasty in Spain, several cases were raised. In fact, some historians suspect that precisely incestuous marriages were what led to the extinction of the lineage, at least in Spanish lands.

This is why, in the year 1700, King Charles II died at 38 without leaving heirs. And many believe that the monarch was barren due to congenital malformations resulting from centuries of inbreeding in the House of Habsburg.

  1. Nahienaena Princess:

Nahienaena was a Hawaiian princess who ascended the throne in the 19th century, during a murky transition process in the history of Hawaii. At that time, Christian missionaries began to gain considerable influence in the archipelago. Entering into direct conflict with local leaders, who were trying to preserve their beliefs.

Nahienaena, daughter of King Kamehameha and Keopuolani, was raised by her mother’s choice in faith. The problem was that, although Nahienaena was a follower of Christianity.

Nahienaena Princess
Nahienaena Princess

Hawaiian monarchs promoted union between members of the same family, and she ended up marrying her own brother.  The marriage angered the Christians and converted subjects of the archipelago, and the poor princess received a rejection from her people.

After this, the Hawaiian princess remained isolated until the baby was born – a girl who, unfortunately, only survived for a few hours.  Nahienaena, meanwhile, was isolated from the world full of guilt until her death, just a few months later.

Conclusion

It is not always a fact that the offsprings from the inbred marriages are always abnormal or will have to suffer from certain hereditary diseases. Some offsprings can even be healthier and intelligent.

So it is not guaranteed that the offspring will suffer from the Disease. However, the prevalence of hereditary diseases and abnormalities in such offsprings are more common than normal children.

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Ankur Pradhan

Ankur Pradhan, a registered and practitioner staff nurse in Kanti Bal Hospital, Kathmandu, Nepal and worked in Abudhabi medical center as a staff nurse. She has written some health-related books as well.

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