Abstract
Background Premarital screening and genetic counseling are key preventive measures for reducing hereditary conditions in regions with high consanguinity, such as the United Arab Emirates. Understanding the knowledge, attitudes, and practices of couples attending premarital clinics is essential for improving service uptake and guiding targeted educational strategies. Methodology A multi-center, cross-sectional study was conducted from April to June 2025 across 23 premarital clinics within Emirates Health Services (EHS). Individuals aged 18 years or older who spoke Arabic or English and provided consent were included. Data were collected using a validated questionnaire administered through the EHS Data Hub. Descriptive and inferential analyses were performed to assess factors associated with knowledge, attitudes, and practices. Results A total of 255 participants were included; 66.7% were male, and 54.1% were aged 30-45 years. More than half were university graduates and employed. Good knowledge was reported by 77.3% of participants, positive attitudes by 92.2%, and good practice by 58.0%. Lower knowledge levels were more common among younger participants, males, and those with lower educational attainment. Females had higher odds of good knowledge (odds ratio (OR) = 2.57, 95% confidence interval (CI) = 1.26-5.27). Participants older than 45 years had higher odds of reporting good practice (OR = 4.15, 95% CI = 1.20-14.34). Good knowledge (OR = 2.27) and positive attitudes (OR = 24.09) were significant predictors of good practice. Conclusions Couples demonstrated strong knowledge and attitudes toward premarital screening and genetic counseling, although practice levels were comparatively lower. Targeted educational initiatives, especially for younger individuals, are needed to enhance engagement and bridge the knowledge-practice gap.