Maternal aflatoxin exposure during pregnancy and adverse birth outcomes in Uganda
Date
2019-04
Authors
Lauer, Jacqueline M.
Duggan, Christopher P.
Ausman, Lynne M.
Griffiths, Jeffrey K.
Webb, Patrick
Wang, Jia-Sheng
Xue, Kathy S.
Agaba, Edgar
Nshakira, Nathan
Ghosh, Shibani
Version
Published version
OA Version
Citation
J.M. Lauer, C.P. Duggan, L.M. Ausman, J.K. Griffiths, P. Webb, J.-S. Wang, K.S. Xue, E. Agaba, N. Nshakira, S. Ghosh. 2019. "Maternal aflatoxin exposure during pregnancy and adverse birth outcomes in Uganda." Maternal and Child Nutrition, Volume 15, Issue 2, pp.e12701-. https://doi.org/10.1111/mcn.12701
Abstract
Aflatoxins are toxic metabolites of Aspergillus moulds and are widespread in the food supply, particularly in low- and middle-income countries. Both in utero and infant exposure to aflatoxin B1 (AFB1 ) have been linked to poor child growth and development. The objective of this prospective cohort study was to investigate the association between maternal aflatoxin exposure during pregnancy and adverse birth outcomes, primarily lower birth weight, in a sample of 220 mother-infant pairs in Mukono district, Uganda. Maternal aflatoxin exposure was assessed by measuring the serum concentration of AFB1 -lysine (AFB-Lys) adduct at 17.8 ± 3.5 (mean ± SD)-week gestation using high-performance liquid chromatography. Anthropometry and birth outcome characteristics were obtained within 48 hr of delivery. Associations between maternal aflatoxin exposure and birth outcomes were assessed using multivariable linear regression models adjusted for confounding factors. Median maternal AFB-Lys level was 5.83 pg/mg albumin (range: 0.71-95.60 pg/mg albumin, interquartile range: 3.53-9.62 pg/mg albumin). In adjusted linear regression models, elevations in maternal AFB-Lys levels were significantly associated with lower weight (adj-β: 0.07; 95% CI: -0.13, -0.003; p = 0.040), lower weight-for-age z-score (adj-β: -0.16; 95% CI: -0.30, -0.01; p = 0.037), smaller head circumference (adj-β: -0.26; 95% CI: -0.49, -0.02; p = 0.035), and lower head circumference-for-age z-score (adj-β: -0.23; 95% CI: -0.43, -0.03; p = 0.023) in infants at birth. Overall, our data suggest an association between maternal aflatoxin exposure during pregnancy and adverse birth outcomes, particularly lower birth weight and smaller head circumference, but further research is warranted.
Description
License
This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial License, which permits use, distribution and reproduction in anymedium, provided the original work is properly cited and is not used for commercial purposes.© 2018 The Authors.Maternal and Child NutritionPublished by John Wiley & Sons, Ltd.