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Objective: To identify the characteristics of women in consanguineous marriage and their effects on reproductive behavior, adverse pregnancy and fetal outcomes. Study Design: Cross-sectional comparative study. Place and Duration of Study: Department of Obstetrics and Gynaecology, Pak Emirates Military Hospital, Rawalpindi, from Jan 2017 to Oct 2017. Methodology: After fulfilling the inclusion and exclusion criteria, patients were divided into two groups, consanguineous and non-consanguineous group. Data was collected at the time of delivery, whether vaginal delivery or cesarean section. It included demographic profile and clinical factors. Then all the newborn babies were followed up to discharge from the hospital for neonatal outcomes. Results: There were 1381 participants included in the study. First cousin marriages accounted for 31.1%, second cousin marriages 14.3% and those not in relation were 54.6%. Consanguinity had significant association with age (p=0.03) and ethnicity (p=006). Significant association with consanguinity was found for threatened preterm labour (p=0.04), preterm delivery (p=0.04), nursery admissions (p<0.01), and neonatal outcomes (p<0.01). Low education was found to be 2.46 times more likely to be with consanguinity. Pathan ethnicity gave 1.75 times positive association. Amongst neonatal outcome measures, early neonatal deaths were found two times more likely for consanguinity as compared to non-consanguinous cases. Conclusion: Consanguinity is very common in Pakistan especially in some ethnic groups. Despite targeting a homogenous group, consanguineous marriages were associated with much higher risk of neonatal intensive care unit admission, stillbirth, perinatal mortality and congenital abnormalities.

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