Marriage Rates Research Articles

Thyroid Autoimmune Disease among Emirati Patients: A Retrospective Analysis of the Patients’ Characteristics

Background: Autoimmune thyroid disease (AITD) is a serious and treatable disease that could be associated with other autoimmune disorders. It is a common cause of hypothyroidism in adult females. The diagnosis is established by detecting serum antithyroid antibodies. The disease slowly progresses, and the treatment includes thyroid hormone replacement in cases of hypothyroidism. Objective: The aim of this study is to investigate the clinical presentation, laboratory findings, and comorbidity factors involved in autoimmune thyroid disease among Emirati citizens in the UAE. Methods: Medical records from Advanced Cure Diagnostic Centers were reviewed in a retrospective study over the period of four years from 2018 to 2022. The patients population included those who attended the Endocrinology Unit and others seen by the rest of the medical staff. Patients were considered to have AITD if they tested positive for thyroid peroxidase antibodies (TPOAb), thyroglobulin antibodies (TgAb), or both. The data collected was evaluated using descriptive analysis to provide a basic summary of the patients sample and dataset. Unpaired t-test was used to compare the mean value of elevated autoantibodies in males and females. Results: Of the 366 Emirati nationals who were tested for autoimmune thyroiditis, 220 (60%) had an abnormal result for TPOAb and/or TgAb. Among the 220 patients who had an abnormal result for TPOAb and/or TgAb, 188 (85.5%) were females, and 100 patients (45.5%) were in the age group between 31 and 40 years. 42% were in a euthyroid state and 42% presented with hypothyroidism. Only 7% presented with hyperthyroidism, 5% with subclinical hypothyroidism, and 2% with subclinical hyperthyroidism. An analysis of the comorbidity factors revealed that 142 (65%) patients with obesity, 82 (37%) with a family history of thyroid disease, 77 (35%) with hyperlipidemia, 14 (6%) with hypertension, and 11 (5%) with diabetes. Conclusion: This is the first publication intended to address AITD in Emirati citizens. Our findings concur with the international data regarding the prevalence among middle-aged females. Eighty-four percent of the positive patients either presented with no abnormality of their thyroid gland function or with hypothyroidism. With the alarming increase of obesity in the UAE, we found it to be the single most important and preventable comorbidity factor present in 65% of the studied population. This is followed by a family history of first-degree relatives with thyroid disease in 37% of the participants, due to the high rate of consanguineous marriages in the UAE.

THE EFFECT OF RELIGIOSITY AND SOCIAL SUPPORT ON MARRIAGE READINESS IN THE YOUNG ADULT AGE GROUP

Indonesia has experienced a decline in marriage rates in the last ten years. Religiosity and social support have an important role in preparing individuals for marriage. This study aims to analyze the influence of young adult characteristics, family characteristics, religiosity, social support, on marital readiness in the young adult age group. The research design used was a cross-sectional study with a quantitative approach. This study involved unmarried young adults aged 21 to 30 years. Respondents in this study totaled 60. The research location was in the Central Bogor Sub-district, Bogor City, West Java. Nonprobability sampling was conducted using purposive sampling technique. The results of the t test obtained a significant difference between the religiosity of men and women. The correlation test shows that there is a significant positive relationship between respondents' age, number of families, religiosity, social support and marital readiness. The regression test results show that income, number of family members, and religiosity have a significant positive effect on marital readines.

Fertility and nuptiality changes in Central and Eastern Europe: 1982-1993

Central and east European countries are in the midst of a major demographic change, that for the most part appears to have been brought about by the on-going political, economic and social transformation of these countries. The strength of the change varies considerably across the counties, quite likely as a consequence of the variations in the depth and breadth of the transformation and the attitude of the people towards it. It appears that, at least, a few years will elapse before the demographers studying these countries will be able to draw a relatively comprehensive picture of the demographic developments in these countries since the turn of the 1980s. This paper seeks to contribute to this picture by documenting changes over time in fertility and first marriage in more than half of the transition countries, which appear to have been associated with the transformation under way. The analysis focuses on the time patterns in the levels and timing of overall fertility and first marriage among women during 1982-1993. It does not seek to explain how the various aspects of the transformation might have influenced those patterns; this would require a separate analysis. Having included in the analysis several years prior to the onset of the transformation, we seek to answer the following questions: What were the nature, timing and magnitude of the changes in overall fertility and first marriage, which are respectively measured by the period total fertility rate and the period total first marriage rate? Were the changes in first marriage accompanied by those in non-marital cohabitation? Although interesting in its own right, this question is addressed as a side issue due to data limitations, by looking at the proportions of extramarital births. And lastly, were the shifts in overall fertility and first marriage accompanied by those in their timing, as measured by the mean age of childbearing and the mean age at entry into first marriage, respectively? The analysis is cast within a broader European context by making comparisons between the countries with economies in transition and selected European countries with market economies.

Az egyes felekezetekhez tartozók demográfi ai jellemzői a Magyar Korona országaiban (Magyarország és Horvátország) a 20. század elején/ az első világháború előtt

Th e aim of this study is to examine the relationship between the level of modernization and the most important demographic indicators of religions. Correlation analyses, which helped us to draw the conclusion, were produced by Statistica for Windows. Our study is based on statistical publications on national level. Hungary was one of the most diversified countries in terms of religions before World War I. Croatia was different from Hungary in terms of religious diversity, as the majority of its population was Roman Catholic and 25% Orthodox. First, we examine the relationship between religion and mother tongue. Then we analyse the demographic indicators of each religion. What immediately attracts our attention is the great diff erence in all indicators, like crude birth, death, natural increase and marriage rates. But more sophisticated indicators behave in similar manner. There was considerable diff erence in fertility, in rate of infant and child mortality. In addition, seasonality of marriages, marital age and the rates of religiously mixed marriages vary greatly from denomination to denomination. Moreover, there was considerable difference in the demographic indicators of the same religions between Hungary and Croatia.

Problematika Pencegahan Perkawinan Anak di Desa Pamboborang

This research is qualitative research taking the research location in Pamboborang village, Banggae District, Majene Regency, West Sulawesi. A normative juridical and sociological research approach where the primary data sources for this research are parents and Pamboborang village officials. The results of this research state that promiscuity, pregnancy out of wedlock, culture and legal awareness are factors that greatly influence the high rate of child marriage in Pamboborang village. The role of law enforcers such as local government, the courts, the Regional Population and Family Planning Agency (BKKBD) and the Health Service are institutions that also have an important role in overcoming these factors. Socialization can be carried out well to educate and provide understanding about the positive and negative impacts of child marriage that occurs in Pamboborang village. It is hoped that the target of this education will be more focused on parents in Pamboborang village because parents should have the greatest role and responsibility to look after and protect their children from all negative actions and actions outside the home. Based on several factors that are the cause of the high rate of child marriage in Pamboborang village, it is hoped that the role of parents will be maximized, so that children who have fallen into promiscuity and juvenile delinquency will be taken in and educated better, rather than resorting to marriage. If the child is pregnant out of wedlock then the role of the parents is not only to get the child married, but the parents have a role to continue to provide advice and assistance to the child of the young couple, so that the marriage they build can create a happy and eternal marriage based on the Almighty God One.

Aging with long-term physical disability: Cohort analysis of survey sample in the U.S.

Chronic health conditions, secondary conditions, and decreasing functional ability related to aging and/or changes in underlying impairment may influence participation for persons aging with long-term physical disability (AwD). To examine sample integrity and baseline findings through exploration of associations of sociodemographic, health, and disability factors with social participation for persons AwD. This is a longitudinal cohort study following persons AwD over three years, reporting baseline cohort study data. A convenience sample of 474 persons AwD aged 45-65 reporting physical disability of ≥5 years' duration was recruited through community organizations and social media. The cohort was majority female (66.7%) and single (62.0%), and over one-third (38.6%) was non-White. Pain, fatigue, depression, ability to participate in, and satisfaction with, social roles and activities were measured with the Patient Reported Outcomes Measurement Information System. Results were manually compared against AwD study samples identified through a focused literature review and national census data. Participants aged 55-60 and 61-65 had significantly lower rates of employment and marriage and higher rates of living alone than participants aged 45-54. Participants reported higher rates of fatigue, pain, and depression and lower ability to participate in, and satisfaction with, participation in, social roles and activities than the general population. Ability to participate and satisfaction with participation were highest among Black/African American participants. Participants reported higher rates of common AwD symptoms and lower ability to participate and satisfaction with participation than the general population, consistent with prior studies of AwD samples. This cohort reflects the AwD population and can be considered an AwD sample, comparable to those found in existing literature. The focus of future analyses will be to gain a greater understanding of chronic health conditions, incidence of falls, engagement in everyday life activities, and the impact of the environment.

The Impact of Early Marriage on the Life Satisfaction, Education and Subjective Health of Young Women in India: A Longitudinal Analysis

Despite progress in reducing rates of early marriage, it is still a widespread practice in India accounting for 30 per cent of the world’s early marriages. Understanding its impacts is thus of high importance to global gender equality goals. This article examines the impact of early marriage on multi-dimensional aspects of well-being: life satisfaction, subjectively assessed health and educational attainment. Difference-in-differences analysis with propensity score matching examines causal effects using Young Lives Study data. The analysis shows women who married early experience a trajectory of lower life satisfaction which is in evidence before marriage, even at age 12, persisting until the latest survey at age 22. There is no evidence of a causal negative effect of early marriage on life satisfaction; the relationship is more complicated, linked to trajectories of deprivation which commence from a very young age. In contrast, early marriage negatively affects women’s self-reported health and educational attainment by age 22.

The psychosexual and psychosocial impacts of polygamous marriages: a cross-sectional study among Somali women

BackgroundPolygamous marriages are common in many Africa countries. This study aimed to document psychosexual and psychosocial problems of Somali women engaged in monogamous or polygamous marriages.MethodsThis cross-sectional study included 607 consecutive women who had presented between June 7 and October 1, 2022, to the Department of Gynaecology of Mogadishu Somali Turkey Training and Research Hospital in Mogadishu, the capital city of Somalia. Data included maternal age, type of marriage (polygamy, monogamy, and arranged marriage), wives’ education, husbands’ education, husband income, residence area (rural or urban), number of marriages, living in houses (same or different), number of co-wives, and age of marriage. The participants were asked to complete three questionnaires: The Female Sexual Function Index (FSFI), the Rosenberg Self-Esteem Scale (RSE), and the Brief Symptom Inventory-18 (BSI-18).ResultsOf 607 women, 435 (71.7%) had monogamous marriages and 172 (28.3%) had polygamous marriages. The mean age was 29.0 ± 7.2 years (range 16–46). In polygamous marriages, the mean number of wives a husband had was 2.4 ± 0.7 women (range 2– 4). The overall incidences of sexual dysfunction, low self-esteem and arranged marriage were 59.8%, 79.4% and 64.4%, respectively. Wives in polygamous marriages differed from those in monogamous marriages with significantly higher rate of illiterateness (41.9% vs. 27.4%, p = 0.004). Increases in husband income corresponded to higher rates of polygamous marriage. Women in polygamous marriages had significantly lower scores in the desire, arousal, orgasm, and satisfaction sub-domains. Sexual dysfunction, with a significantly increased rate among women in polygamous marriages. Polygamous marriages were associated with significantly higher levels of anxiety, and depression, and a significantly higher total BSI score (p = 0.010, p = 0.004, and p = 0.020, respectively). Women in both groups had similar levels of low self-esteem (p > 0.05). In univariate analysis, polygamous marriage was in significant inverse associations with the total FSFI score and subdomain scores of desire, arousal, orgasm, satisfaction, and sexual dysfunction and in significant associations with the BSI total score and subdomain scores of anxiety and depression (p < 0.05).ConclusionOur findings suggest that women in polygamous marriages experience considerably higher psychosexual and psychosocial adverse effects as compared with their monogamous counterparts.

Breast cancer mortality among ultra-orthodox and non-ultra-orthodox Israeli women: A retrospective cohort study

BackgroundBreast cancer is the leading cause of cancer death in Israeli women. Previous studies found socioeconomic status and other risk factors impact breast cancer outcomes. The ultra-orthodox community is characterized by a longer life expectancy, lower rates of mammography performance, higher fertility rates and other sociodemographic variables that may be related to breast cancer mortality. This study examined disparities in breast cancer mortality between ultra-Orthodox and non-ultra-Orthodox Israeli women. MethodsThis retrospective cohort study for breast cancer mortality included the all Jewish Israeli citizens women born between 1940 and 1960 and lived in communities with over 20,000 residents (n = 628,617). Data was collected from various sources, monitoring a period of 31 years; for each participants, their sociodemographic characteristics were compiled from the population registry, the tax authority, the education registry, and the Central Bureau of Statistics (CBS). Variables included religiosity, age, marital status, children, origin, education, and income. Multivariable Cox models evaluated predictors of mortality. ResultsOf the 628,617 women in the study, 29,611 were ultra-Orthodox. Ultra-Orthodox women had higher marriage rates, more children, and lower secular education and income. Mortality was 108.8/100,000 overall, lower among ultra-Orthodox (83.4/100,000) than non-ultra-Orthodox women (110.1/100,000) despite their risk factors. Using a multivariate model to evaluate the association between ultra-Orthodoxy and breast cancer mortality, the study found higher breast cancer mortality rate among non-ultra-Orthodox women compared to ultra-Orthodox women (HR = 1.491; 99% CI = 1.232, 1.804). Associations with sociodemographic variables were different for each group. ConclusionsAlthough ultra-Orthodox women have socioeconomic risk factors, breast cancer mortality was lower than non-ultra-Orthodox women. Further research on potential cultural and religious factors influencing mortality is warranted. These findings highlight the importance of evaluating predictors within specific populations.

Tracking household carbon inequality in China: Composition effect or coefficient effect?

Reasonable allocation of carbon emission reduction tasks requires addressing household carbon inequality. This study aims to track characteristics of household carbon inequality in China using the recentered influence function (RIF) based on the Household Tracking Survey data in 2018 and the multi-regional input–output table. The Oaxaca–Binder decomposition based on RIF further decomposes household carbon inequality based on spatial heterogeneity into composition and coefficient effects. The results indicate that (1) household carbon inequality is widespread in China, generally close to the 60/30 distribution, favouring high-income families. Furthermore, (2) increases in income, wealth and economic burden and declining marriage rate promote household carbon inequality, which is suppressed by the development of education and the Internet and the increase in car ownership. Additionally, (3) the carbon inequality of urban households is smaller than that of rural households, which is contributed by the composition effects of family size, education, car ownership, Internet development and the coefficient effect of income and housing. Finally, (4) under the composition effect of family size and the coefficient effect of income, the household carbon inequality in the eastern region is smaller than in the central and western regions.

Mutations in COL6A Gene Family Responsible for Muscular Dystrophies in Three Unrelated Families.

Muscular dystrophy is an inherited disease with clinical and genetic heterogeneity. Muscle weakness is the primary symptom of these disorders that often leads to disability and death. The overall prevalence for all types of muscular dystrophies worldwide is 19.8-25.1 per 100,000 population. Autosomal recessive types of muscular dystrophies are more common in Iran, likely due to the high rate of consanguineous marriage. We aimed at deciphering molecular defects in three unrelated families with muscular dystrophies not related to Duchene MD or limb girdle muscular dystrophies. We are reporting families having affected children with MD owing to the mutations in three genes related to the COL6A (collagen type VI, alpha subunit) gene family. Three unrelated families, who had at least one member affected with MD and for whom a definite molecular diagnosis was not provided by routine methods, were investigated by WES and confirmed by Sanger sequencing. In the first family, a homozygous variant was found in the COL6A3 gene (NM_004369.4:c.4390C>T:p.Arg1464Ter), which explains the clinical symptoms observed in this family. In the second family, two homozygote missense variants with possible relevance to the patient’s phenotype were identified in COL6A1 and COL6A2 genes (NM_001848.2:c.803A>G: p.Glu268Gly and NM_001849.3:c.2489G>A:p.Arg830Gln). Also, a heterozygous pathogenic variant in the COL6A2 gene (NM_001849.3: c.1053+1G>T) was detected in the third family. WES can serve as an effective method for detecting the causative mutations in families with unresolved cases of MD. The data provided herein broadens the spectrum of mutations causing MD in Iran.

State and sex-specific trends in the annual incidence of child marriage in the United States since the year 2000

ObjectivesChild marriage, defined as marriage before 18 years of age, is a violation of human rights with harmful consequences for population health, educational attainment, and economic opportunities. Child marriage is legal across most of the United States but how often it happens is challenging to estimate. We measured state and sex-specific trends in the annual incidence of child marriage in 41 states and the District of Columbia. MethodsWe collected data from marriage certificates filed between 2000 and 2019. These certificates allowed us to identify marriages that occurred within each state and involved a spouse under the age of 18. We divided the number of 15–17-year-olds married in each year by the number of children in that age range living in the state in that year and graphed these annual rates to present trends over time. ResultsThe rate of child marriage declined substantially across the United States between 2000 and 2019. Over 75 % of all married children in each state were girls. Girls married men who were an average of 4 years older than they were, and the age gap was substantially larger when girls married than when boys married. ConclusionsChild marriage continues across most of the United States and reflects gender inequities in American society. The continued legality of marriage before the age of 18 is at odds with the country's commitment to eliminate child marriage by the year 2030 and violates the human rights of children, primarily girls, across the country.

Personal advertising and dating culture in World War II Finland

ABSTRACT I analyze how personal advertising affected marital and sexual culture in Finland during World War II. The practice of seeking intimate company through newspapers was nearly non-existent in Finland before the war, but in wartime grew into a nationwide mass phenomenon due to the gender imbalance caused by men’s departure for the front. Wartime personal advertising was different than that in peacetime. Unlike the typical situation, when advertisements are mostly used by the middle-aged, most of the advertisers during the war were young adults in the prime age of courtship. Their active advertising accounted for the high marriage rates during the war and had a liberating effect on Finnish sexual culture. The active posting of personal advertisements by women was also noteworthy. Traditionally, they were expected to passively await men’s initiatives in the marital market. However, during the war, women advertised in the same numbers as men, indicating that the freedom offered by advertisements was particularly important for them. Nevertheless, the transformation of sexual culture is not explicitly evident in the advertisements. The Finnish personal advertising culture was unique in that even adults undoubtedly seeking serious relationships only expressed wishes for correspondence in advertisements due to the conservative sexual culture of the country. The case illustrates challenges in using personal advertisements in the historical analysis of mate selection.

Marriage in persons with severe mental illness: A narrative review-based framework for a supported relationship.

Studies in the past have shown the effect of mental illness on marriage in persons with severe mental illnesses (SMIs). Primary care and family physicians have a major role in addressing marriage-associated dilemmas in their life. The literature search was conducted from databases such as PubMed, ProQuest, EBSCO, Scopus, and Google Scholar for understanding the context and the problem in-depth for bringing out the narrative-review based framework for addressing the dilemmas. Marriage rates in persons with SMI are high in Eastern countries. Marriage in persons with SMI enhances social support and prevents the stigma of being unmarried. Disability, unemployment, stigma, and disclosure-related issues are barriers to getting desirable alliances. Evidence based interventions are available to reduce the associated distress to an extent. Published peer-reviewed literature has pointed out that marriage plays a significant role in the life of persons with SMI and their families, especially in Asian countries where marriage is an important social institution. It can have a positive impact or can lead to relapse, marital conflicts, and divorce based on contextual and clinical factors. Hence, there is a need to come up with tailor-made interventions to address marriage-related expectations in persons with SMI.

Chosen Family? Rethinking “Relationship Status” in LGB Cognitive Aging Research

AbstractBackgroundExisting studies have shown the importance of marital status and quality on later‐life cognitive health, including dementia risk and likelihood of timely dementia diagnosis. Yet, much evidence comes from different‐sex couples’ experiences, for whom marriage remains the norm and unmarried persons face social and material costs. In contrast, where same‐same marriage is legal in North America and Europe, marriage has not yet become the norm: same‐sex couples (SSCs) have lower marriage rates than different‐sex couples. SSCs also tend to structure their relationships differently across a range of domains, from household labor to sexual nonmonogamy. Throughout Europe and North America, older lesbian and gay people are also more likely to be single, to live alone, and to have no living children than straight or bisexual people; as a result, the former tend to rely less on partners or biological family to meet their social needs. Unlike straight men, for example, gay and bisexual men tend to rely less on their partners or daughters to forge and maintain social and community connections, instead relying on “chosen families”.MethodGiven their unique prominence for sexual minorities, this paper uses population‐based surveys from the US (HRS) and Europe (ELSA and SHARE) to investigate measures of non‐biologically familial social bonds, including whether measures of friendship, social connectedness, and community involvement function similarly to marital status.ResultIn the US, which has the highest marriage rates and a deeply entrenched “marriage culture”, LGB participants in the HRS (1998‐2018; n = 23,035) who indicate having never been married perform better cognitively at baseline than married LGB people (β = 1.5; p = 0.05), while never‐married straights perform worse (β = ‐0.9; p &lt;0.01).ConclusionRelationship factors have a different association with cognitive health for LGB people than straight people, yet these remain unexplored in their effects on cognitive aging and queerer pathways to good cognitive health.

Recent Changes in Marriage Formation and Dissolution Behaviour in Czechia

Marriage formation and dissolution behaviours have changed significantly over time in Czechia. This article studies in greater detail the marital behaviour changes observed in the period 1993–2022 using the LIPRO 4.0 multistate programme, which allows for a detailed analysis of changes in life expectancy according to years spent in each marital state, marriage formation and dissolution behaviours, and the average ages at the time of different marital status events. The probabilities for the transition to the divorced and to the remarried state at selected ages are also presented, along with a status-quo projection of the Czech population until 2030. The results indicate the continued postponement of marriage and subsequent marital events. Czechs have been spending an increasing time never-married since the establishment of Czechia. However, recent improvements in first marriage and remarriage rates at the same time as declining divorce rates since 2019 suggest a renewed interest in marriage. Despite these positive developments, the population projection indicates a continued increase in the never-married population.

Socialization of Jo Kawin Bocah as an Effort to Reduce Early Marriages for Vulnerable Groups

Early marriage in Indonesia is a problem that is not only related to marriage law but also related to issues of child protection and human rights. The Parole and Probation Office as an institution that also plays a role in handling Juveniles involved with the law shows its involvement and collaborates with the Women's Empowerment Service, Child Protection, Population Control and Family Planning (DP3AP2KB). Central Java created a program to prevent child marriage called Jo Kawin Bocah, but not all teenagers know about the program. The aim of conducting outreach is to reduce the rate of early marriage among Indonesian children and disseminate information related to the program. The research method consists of counseling and field practice. Reducing the rate of early marriage, especially in communities with low levels of education, is one movement to realize the success of the program.

Child Exploitation by Parents in Early Marriage: Case Study in Cianjur West Java, Indonesia

Parents should protect their children. Child exploitation by parents is a cruel act. One form of parental deprivation of children’s rights is to marry them at an early age. In Indonesia, the rate of early marriage is still above 10% of all marriages. There is a trend of early marriage with Arab men in tourist destinations such as Puncak-Cianjur, West Java, after the increasing number of tourist visits from the Middle East. This research used a qualitative research method with a phenomenological approach to explore informant' experiences, interpret their experiences, and give meaning to their experiences. Data were collected through observation and in-depth interviews using the Snow Bowling Effect method. The results of the research were analyzed using the framework method. This research found that parents determine the occurrence of early marriage. The drivers of early marriage are economic interests and religious dogma. Parents were influenced by biyong (marriage broker) in making decisions. Biyong took advantage of half of the dowry. Meanwhile, children’s consent to marry was influenced by religious doctrines that caused them to be altruistic and follow their parents' wishes. This research recommends the government be stricter in supervising foreign tourists and socializing the dangers of early marriage and mutáh marriage with foreigners.

Evaluating a sexual and reproductive health education program in Mozambique: A mixed method study

Background: Early and inappropriate messages regarding sexuality and marriage taught during adolescent initiation rituals teachings in Mozambique are considered a determinant of high rates of early marriage, adolescent pregnancy, and maternal mortality. The Alert Community for a Prepared Hospital implementation research project in Natikiri, Nampula, Mozambique (2016-2020) identified adolescent initiation rituals counsellors and traditional authorities as pertinent agents to provide sexual and reproductive health education to adolescents during the initiation rituals. Objective: Develop, apply, evaluate, and disseminate a modern, transformative education tool, about sexual and reproductive health and rights, for counselors to use with adolescents during initiation rituals in Northern Mozambique. Methods: This is an exploratory descriptive and intervention study, using mixed method approaches. Findings: Results suggest, the education tool was well accepted by rituals counsellors, community leaders and the adolescents who attended the initiation rituals. It was shown to improve adolescent’s knowledge and lead to a positive behaviour change in sexual and reproductive health and rights. Conclusions: This intervention may be replicated at a national level with a low cost and significantly contribute to reducing adolescent pregnancy and early marriages and improving maternal and child health.

High Prevalence of a Rare Bleeding Disorder: A Report from Glanzmann Thrombasthenia Registry of Al-Madinah, Saudi Arabia

Introduction Glanzmann thrombasthenia (GT) is a hereditary bleeding disorder caused by a defect or deficiency of platelet glycoprotein IIbIIIa. Though GT is considered a rare bleeding disorder, some countries in the Middle East report a high prevalence of GT. Aim Description of GT patients' prevalence, demographic, clinical, and genetic features in AlMadinah, Saudi Arabia. Methods This is a 20-year report from the AlMadinah GT registry in the Madinah Hemophilia Comprehensive Care Center. The registry has included all patients with a confirmed diagnosis of GT. To label a patient as GT, He must have absence or abnormal response in all agonists except ristocetin plus absence or reduced expression of platelet glycoprotein IIbIIIa on Flowcytometry. Next-generation sequencing is used to target sequencing for Molecular testing. The extracted data underwent an analysis process, where 136 GT patients were identified. Only 125 cases have complete data in records. Statistical analysis made via a statistical package of social sciences (SPSS) version 23. The research and ethical committee approved the study. Results The prevalence of GT among Saudis in AlMadinah, Saudi Arabia, based on the Saudi population in 2022, is 1:10,000. One hundred twenty-five GT patients were studied: 67 (54%) females and 58 (46%) males. The median age at the time of the report was 16.5 (10 days to 56 years). Ninety-nine (79%) patients have type 1 GT. Out of 108 (86%) whose Consanguinity status was recorded, 106 (98%) GT patients are products of consanguineous marriage. Seventy (65%) patients were products of first-degree cousin parents. Family history of GT was reported in 107 (86%) cases. Twenty-five families have more than one sibling (2-5) with GT. A single tripe has 50 members with GT. The median age at presentation is 2 years (7 days to 11 years). The most common symptoms are gum bleeds, Epistaxis, and Bruises. Eighteen (16%) patients suffered from a severe bleeding course (defined as bleeding continued for more than 3 days, drop in hemoglobin for more than 2 g / L from the baseline, or needed admission to the intensive care unit). Forty (35%) patients had a moderate course (bleeding requiring hospital admission and not filling the criteria for severe one). Fifty-seven (50%) patients had a mild clinical course (bleeding can be stopped at home). Eighteen (17%) patients had bleeding episodes more than once a month, 34 (32%) had six or fewer bleeds per year, and 57 (52%) patients had one bleeding episode per year. Menorrhagia affected 35 (86%) ladies and girls. Hormonal therapy has been used at least once in their lives to interfere with the menstrual cycle in 39 (95 %) patients. Twenty-eight pregnancies were reported, producing 24 babies (13 girls and 11 boys). A postpartum hemorrhage took place after 18 deliveries (75%). Mild to moderate pregnancy-related bleeding occurred in 7 pregnancies. Iron deficiency anemia was found in 66 (66%) patients out of 100 whose iron status was reported. Eighteen mutations have been identified: 15 mutations in the ITGA2B gene and 3 mutations in the ITGB3 gene (table 1). The mutation ITGA2B:exon13:c.1210+5G&amp;gt;A is a novel mutation found only in one tripe, where all 12 GT patients in this tripe carry this mutation. The mutation ITGA2B: exon20:c.1879-2A&amp;gt;G is the most frequent mutation affecting one tribe only, and all 42 GT patients who descend from this tribe carry this mutation. The second frequent mutation is ITGB3:exon13:c.2112delC, involving 28 GT patients. Though we could not find a correlation between genotype and phenotype, we noticed GT patients carrying mutations exon13:c.2112delC and exon13:c.1210+5G&amp;gt;A running a more severe clinical course compared to patients affected by the mutation ITGA2B: exon20:c.1879-2A&amp;gt;G. Anti-platelet antibodies have been detected in 11 (9%) patients, 2 of them during pregnancy. Apart from Menorrhagia, 10 out of 15 GT patients running severe clinical courses improved when they reached puberty. Conclusions GT is the commonest bleeding disorder in AlMadinah, Saudi Arabia, with a prevalence of 1:10,000. With a high rate of menorrhagia and IDA. The high rate of consanguineous marriage could be a reason for the high prevalence of GT.