Aflatoxin exposure in pregnant women of mixed status of human immunodeficiency virus infection and rate of gestational weight gain: a Ugandan cohort study
Lauer, Jacqueline M.
Natamba, Barnabas K.
Griffiths, Jeffrey K.
MetadataShow full item record
Citation (published version)Jacqueline M Lauer, Barnabas K Natamba, Shibani Ghosh, Patrick Webb, Jia‐Sheng Wang, Jeffrey K Griffiths. 2020. "Aflatoxin exposure in pregnant women of mixed status of human immunodeficiency virus infection and rate of gestational weight gain: a Ugandan cohort study." Tropical Medicine & International Health, Volume 25, Issue 9, pp. 1145 - 1154. https://doi.org/10.1111/tmi.13457
OBJECTIVES: To examine the association between aflatoxin (AF) exposure during pregnancy and rate of gestational weight gain (GWG) in a sample of pregnant women of mixed HIV status in Gulu, northern Uganda. METHODS: 403 pregnant women were included (133 HIV‐infected on antiretroviral therapy (ART), 270 HIV‐uninfected). Women’s weight, height and socio‐demographic characteristics were collected at baseline (~19 weeks’ gestation); weight was assessed at each follow‐up visit. Serum was collected at baseline and tested for aflatoxin B1‐lysine adduct (AFB‐lys) levels using high‐performance liquid chromatography (HPLC). Linear mixed‐effects models were used to examine the association between AFB‐lys levels and rate of GWG. RESULTS: AFB‐lys levels (detected in 98.3% of samples) were higher among HIV‐infected pregnant women than HIV‐uninfected pregnant women [median (interquartile range): 4.8 (2.0, 15.0) vs. 3.5 (1.6, 6.1) pg/mg of albumin, P < 0.0001]. Adjusting for HIV status, a one‐log increase in aflatoxin levels was associated with a 16.2 g per week lower rate of GWG (P = 0.028). The association between AFB‐lys and the rate of GWG was stronger and significant only among HIV‐infected women on ART [−25.7 g per week per log (AFB‐lys), P = 0.009 for HIV‐infected women vs. −7.5 g per week per log (AFB‐lys), P = 0.422 for HIV‐uninfected women]. CONCLUSIONS: Pregnant women with higher levels of AF exposure had lower rates of GWG. The association was stronger for HIV‐infected women on ART, suggesting increased risk.
Rights© 2020 The Authors Tropical Medicine & International Health Published by John Wiley & Sons Ltd 1145. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.