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IJE Advance Access originally published online on February 24, 2009
International Journal of Epidemiology 2009 38(3):690-697; doi:10.1093/ije/dyp141
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Published by Oxford University Press on behalf of the International Epidemiological Association © The Author 2009; all rights reserved.

GSTM1 polymorphisms modify the effect of maternal smoking during pregnancy on cognitive functioning in preschoolers

Eva Morales1,2,3, Jordi Sunyer1,2,4,5,*, Jordi Julvez1,2, Francesc Castro-Giner1,2,5, Xavier Estivill4,5,6,7, Maties Torrent8 and Rafael De Cid5,6,7

1 Center for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.
2 Municipal Institute of Medical Research (IMIM-Hospital del Mar), Barcelona, Spain.
3 Preventive Medicine and Public Health Educational Unit, IMAS-UPF-ASPB, Barcelona, Spain.
4 Universitat Pompeu Fabra (UPF), Barcelona, Spain.
5 CIBER Epidemiología y Salud Pública (CIBERESP), Spain.
6 Genes and Disease Program, Centre for Genomic Regulation (CRG), Barcelona, Spain.
7 Centro Nacional de Genotipado (CeGen), Barcelona, Catalonia, Spain.
8 Area de Salud de Menorca, IB-SALUT, Menorca, Spain.

* Corresponding author. Center for Research in Environmental Epidemiology, Parc de Recerca Biomèdica de Barcelona Dr Aiguader 88, 08003 Barcelona, Catalonia, Spain. E-mail: jsunyer{at}creal.cat


   Abstract

Background Maternal smoking during pregnancy is associated with cognitive deficits in children. Parental factors are proposed as an explanatory. We studied the influence of GSTM1 and GSTT1 polymorphisms on the cognition effects induced by active maternal smoking during pregnancy.

Methods Children (n = 384) from a prospective population-based birth cohort were assessed at 4 years. The McCarthy Scales of Children's Abilities (MCSA) was administrated. Maternal smoking was measured by questionnaire. Genotyping was conducted for null alleles from GSTM1 and GSTT1. Multivariable linear regression models were used to examine the association between active maternal smoking during pregnancy and MCSA outcomes by GSTM1 and GSTT1 genotypes.

Results Maternal smoking during pregnancy (reporting, yes) was inversely associated with global cognitive score among children having null allele for GSTM1 (β = –4.73, 95% CI –9.45 to –0.02); but not among children with present allele (β = –1.04, 95% CI –7.88 to 5.81) (P for interaction 0.089). The interaction remained after adjusting by post-natal maternal smoking (P = 0.081). The effect was stronger for perceptual-performance (β = –3.68, 95% CI –8.39 to 1.03; P for interaction 0.087), quantitative (β = –7.00, 95% CI –17.39 to 3.39; P for interaction 0.048), verbal (β = –3.63, 95% CI –8.43 to 1.17; P for interaction 0.264) and executive function (β = –4.87, 95% CI –9.55 to –0.20; P for interaction 0.127). No interaction was found for GSTT1.

Conclusions GSTM1 deficiency increases the adverse effects of active maternal smoking during pregnancy on cognition in preschoolers, suggesting a biological interaction between child metabolic genes and tobacco smoke components in detoxification process during foetal neurodevelopment.


Keywords Children, neurodevelopment, cognitive functioning, maternal smoking habits, smoking during pregnancy, glutathione S-transferase, polymorphism, gene–environmental interaction

Accepted 20 January 2009


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