The association of low socioeconomic status and the risk of having a child with Down syndrome: a report from the National Down Syndrome Project

Abstract

Purpose Advanced maternal age and altered recombination are known risk factors for Down syndrome cases due to maternal non-disjunction of chromosome 21, whereas the impact of other environmental and genetic factors is unclear. The aim of this study was to investigate an association between low maternal socioeconomic status and chromosome 21 nondisjunction. Methods Data from 714 case and 977 control families were used to assess chromosome 21 meiosis I and meiosis II nondisjunction errors in the presence of three low socioeconomic status factors: (i) both parents had not completed high school, (ii) both maternal grandparents had not completed high school, and (iii) an annual household income of <$25,000. We applied logistic regression models and adjusted for covariates, including maternal age and race/ethnicity. Results As compared with mothers of controls (n = 977), mothers with meiosis II chromosome 21 nondisjunction (n = 182) were more likely to have a history of one low socioeconomic status factor (odds ratio = 1.81; 95% confidence interval = 1.07–3.05) and ≥2 low socioeconomic status factors (odds ratio = 2.17; 95% confidence interval = 1.02–4.63). This association was driven primarily by having a low household income (odds ratio = 1.79; 95% confidence interval = 1.14–2.73). The same statistically significant association was not detected among maternal meiosis I errors (odds ratio = 1.31; 95% confidence interval = 0.81–2.10), in spite of having a larger sample size (n = 532). Conclusion We detected a significant association between low maternal socioeconomic status and meiosis II chromosome 21 non-disjunction. Further studies are warranted to explore which aspects of low maternal socioeconomic status, such as environmental exposures or poor nutrition, may account for these results.

Is drug insurance status an effect modifier in epidemiologic database studies? The case of maternal asthma and major congenital malformations

“…We also observed a higher prevalence of infants with congenital malformations among publicly insured women with social welfare than privately insured women. This is also consistent with the results of prior studies in Europe and North America showing that the prevalence of congenital malformations is greater in the offspring of women with unfavorable maternal socioeconomic factors (Wasserman et al, ; Vrijheid et al, ; Yang et al, ; Kuciene and Dulskiene, ; Olesen et al, ; Varela et al, ; Hunter et al, ).…”

“…The absence of a provincial drug database for individuals who are covered by private drug insurance in Québec has limited research to patients covered by the public drug insurance. Knowing that the mothers' SES is associated with congenital malformations (Wasserman et al, ; Vrijheid et al, ; Yang et al, ; Kuciene and Dulskiene, ; Olesen et al, ; Varela et al, ; Hunter et al, ) and asthma (Litonjua et al, ; Basagana et al, ; Chung et al, ; Eagan et al, ; Hedlund et al, ; Ellison‐Loschmann et al, ; Ekerljung et al, ), it has been suggested that drug insurance status, which could be considered to be a proxy for SES (Chung et al, ), may be an effect modifier in the association between asthma and congenital malformations. Therefore, to investigate this issue, we conducted a study based on a new, large representative cohort of pregnant women who were selected independently of their drug insurance status.…”

Down syndrome as a genetic model to evaluate the role of oxidative stress and transsulfuration abnormalities in autism spectrum disorder: A 10‐year longitudinal cohort study

“…The rate of DS (0.93%) was significantly higher than the reported DS rate of about (0.14%) of live births in the general U.S. population (Parker, Mai, & Canfield, ). However, it was revealed in several previous studies that low socioeconomic status is associated with a significantly increased rate of DS (Christianson, Sherman, & Torfs, ; Hunter et al, ). The data examined in this status was generated from Florida Medicaid, a program that provides healthcare services to low socioeconomic groups, the elevated DS rate observed is consistent with previous studies revealing an elevated DS rate among low socioeconomic populations.…”

Maternal Age and Oocyte Aneuploidy: Lessons Learned from Trisomy 21

“…To further study this effect, we used our data on 1,691 families ascertained through the NDSP [ 68 ] . We assessed MI and MII nondisjunction errors in the presence of three low SES factors: both parents had not completed high school, both maternal grandparents had not completed high school, and an annual household income of <$25,000.…”