title: 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: OBJECTIVE
  Advanced maternal age and altered recombination are known risk factors for Down syndrome cases due to maternal nondisjunction 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).
  
  
  CONCLUSIONS
  We detected a significant association between low maternal socioeconomic status and meiosis II chromosome 21 nondisjunction. 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.
authors.affiliation: Department of Human Genetics, Emory University School of Medicine, Atlanta, Georgia, USA. jhunte4@emory.edu
authors.forename: Jessica Ezzell
authors.initials: JE
authors.lastname: Hunter
authors.forename: Emily Graves
authors.initials: EG
authors.lastname: Allen
authors.forename: Mikyong
authors.initials: M
authors.lastname: Shin
authors.forename: Lora J H
authors.initials: LJ
authors.lastname: Bean
authors.forename: Adolfo
authors.initials: A
authors.lastname: Correa
authors.forename: Charlotte
authors.initials: C
authors.lastname: Druschel
authors.forename: Charlotte A
authors.initials: CA
authors.lastname: Hobbs
authors.forename: Leslie A
authors.initials: LA
authors.lastname: O'Leary
authors.forename: Paul A
authors.initials: PA
authors.lastname: Romitti
authors.forename: Marjorie H
authors.initials: MH
authors.lastname: Royle
authors.forename: Claudine P
authors.initials: CP
authors.lastname: Torfs
authors.forename: Sallie B
authors.initials: SB
authors.lastname: Freeman
authors.forename: Stephanie L
authors.initials: SL
authors.lastname: Sherman
mesh_terms: D000328:Adult; D044383:Black People / Q000235:genetics / Q000706:statistics & numerical data; D016022:Case-Control Studies; D002648:Child; D002891:Chromosomes, Human, Pair 21; D004314:Down Syndrome / Q000453:epidemiology / Q000208:ethnology / Q000209:etiology* / Q000235:genetics*; D004522:Educational Status; D005260:Female; D006630:Hispanic or Latino / Q000235:genetics / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D016014:Linear Models; D008297:Male; D008423:Maternal Age; D008875:Middle Aged; D009035:Mothers / Q000193:education; D015999:Multivariate Analysis; D009630:Nondisjunction, Genetic; D012307:Risk Factors; D012923:Social Class; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D044465:White People / Q000235:genetics / Q000706:statistics & numerical data; D055815:Young Adult
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