Maternal smoking, genetic variation of glutathione s-transferases, and risk for orofacial clefts.
BACKGROUND
Maternal smoking is a known risk factor for orofacial clefts. We investigated whether risk is greater among offspring who lack the genetic capacity to produce glutathione S-transferase enzymes relevant to detoxification of chemicals in cigarette smoke.


METHODS
Using a population-based case-control design, we genotyped 423 California infants with an isolated cleft and 294 nonmalformed controls for null variants of the glutathione S-transferases GSTT1 and GSTM1.


RESULTS
If a mother smoked during pregnancy and her fetus was homozygous null for GSTT1, the risk of isolated cleft lip with or without cleft palate was tripled (odds ratio = 2.9; 95% confidence interval = 1.2-7.2). For fetuses who were homozygous null for GSTM1 and whose mothers smoked >/=20 cigarettes per day, we found nearly a 7-fold increased risk (6.8; 0.82-57). Combined absence of GSTM1 and GSTT1 enzymes among the offspring of smoking mothers was associated with a nearly 6-fold increased risk for cleft lip (6.3; 1.3-42). A similar increased risk for cleft palate was associated with absence of GSTM1, but not for absence of GSTT1.


CONCLUSIONS
Maternal smoking during pregnancy increases risks for clefts among fetuses lacking enzymes involved in the detoxification of tobacco-derived chemicals.
Lammer
Edward J
EJ
Children's Hospital Oakland Research Institute, Oakland, CA, USA. elammer@chori.org
Shaw
Gary M
GM
Iovannisci
David M
DM
Finnell
Richard H
RH
D000328:Adult; D016022:Case-Control Studies; D002971:Cleft Lip / Q000209:etiology* / Q000235:genetics; D002972:Cleft Palate / Q000209:etiology* / Q000235:genetics; D005260:Female; D014644:Genetic Variation; D005982:Glutathione Transferase / Q000235:genetics*; D006801:Humans; D007231:Infant, Newborn; D018811:Maternal Exposure; D009035:Mothers; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects*
D005982:Glutathione Transferase