THE GENETIC BACKGROUND OF SOUTHERN IRANIAN
COUPLES BEFORE MARRIAGE
Nariman A, Sobhan MR, Savaei M, Aref-Eshghi E, Nourinejad R,
Manoochehri M, Ghahremani S, Daliri F, Daliri K,*
*Corresponding Author: Dr. Karim Daliri, Department of Human Genetics, Behbahan Faculty of Medical Sciences, Bashir
Boulevard, Behbahan, Iran. Tel: +98-9374140937. Fax: +98-9374140937. E-mail: karimdaliri@ gmail.com
page: 71
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DISCUSSION
To the best of our knowledge, this is the first study
in Khuzestan Province, Iran (Behbahan City) to investigate
the genetic background of couples before marriage.
We found that most respondents (97.0%) had never been
referred for genetic counseling, and their health care providers
had only referred a few of them for genetic testing
(98.6%) despite the high rate of consanguinity. These
findings suggest that most health service providers in our
setting were not aware of or underestimated the importance
of genetic services. Our respondents were also mostly
unaware of the type of tests they had undergone. These
suggest that both health care providers and the public
would benefit from training in the general concepts of
genetics and their importance before marriage. This cannot
be achieved without increasing the collaboration between
genetic counseling centers, genetic testing laboratories and
health service providers.
DNA copy number variants (microdeletions and duplications),
single gene and complex disorders, chromosomal
aberrations and epigenetic disorders are the main
categories of potential causes of genetic problems. With
the progress in molecular genetics of diseases, each year
about 10 to 15 new tests become available for clinical
genetic testing [10]. As more genes are discovered and the
etiology of more genetic disorders is understood, the role
of genetic counseling in health care systems is expected
to increase. Genetic counseling is the process of helping
people to understand the medical, psychological and familial
implications of genetic contributions to disease. Counseling
should include assessing the chances of occurrence
or recurrence of a disease, management and prevention.
In our study, the main reason for genetic counseling was
consanguinity, whereas other forms of assessments were
mainly ignored. These results are comparable to those
by Fathzadeh et al. [11] who reported consanguinity as
the primary reason for referrals for genetic counseling.
In populations with high rates of consanguineous marriages,
an improvement in the public health genetic service
as well as the education of the public about the risks of
consanguineous marriages is strongly suggested to reduce
the risks. Apart from this, the integration of the genetics
service to the local Primary Health Care facility that is
currently performed at the rural and metropolitan levels
in the province, would be the first step to improve clinical
genetic services in this region. In addition, a number
of reports have noted that health care providers may be
inconsistent in the counseling they provide for consanguinity,
so in this area, they need to increase their awareness of
genetic issues, possibly through self-learning and official
education, in order to make appropriate referrals [12].
Conclusions. The implications of our findings are
useful from both theoretical and practical standpoints.
Despite the key role of genes in the etiology of different
human diseases, some medical professionals may underestimate
their actual value in the process of prevention,
diagnosis and treatment. All couples who plan to marry,
especially those who are related by consanguinity, should
be informed of the risks, benefits, and possible outcomes
of pregnancy and parenthood through genetic counseling
and public education via the media. Furthermore, we
strongly recommend closer collaboration between clinical
genetic counseling centers, genetic testing laboratories and
health service providers at marital counseling centers, as
well as regular training for health service providers such
as physicians and nurses in basic and applied concepts in
human and medical genetics.
Declaration of Interest. The authors report no conflicts
of interest. The authors alone are responsible for the
content and writing of this article.
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