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Aflatoxin exposure in utero and birth and growth outcomes in Tanzania.

Published on Apr 1, 2020in Maternal and Child Nutrition3.305
· DOI :10.1111/MCN.12917
Simone Passarelli3
Estimated H-index: 3
(Harvard University),
Sabri Bromage5
Estimated H-index: 5
(Harvard University)
+ 5 AuthorsWafaie W. Fawzi65
Estimated H-index: 65
(Harvard University)
Abstract
Some evidence suggests that aflatoxin may contribute to the high prevalence of stunting observed in low-income countries. Whereas several studies have been conducted in West Africa, fewer exist in East Africa and even fewer in nonagricultural contexts. We analyzed serum samples from 400 iron-replete, nonanemic pregnant women from a cohort in Dar es Salaam, Tanzania to determine the extent and magnitude of exposure to aflatoxin and to study the relationship between levels of aflatoxin exposure in utero and infant birth and growth outcomes. Ninety-nine percent of women had detectable concentrations of aflatoxin B1-lysine (AFB1-lysine), with a median level of 1.4-pg/mg albumin, indicating a much lower level compared to studies of rural populations in sub-Saharan Africa. Our results do not show a statistically significant relationship between AFB1-lysine levels and birth weight, small for gestational age, or prematurity. We observe a small statistically significant reduction in gestational age at delivery (0.47 weeks; 95% CI: -0.86, -0.07) as the natural log of AFB1-lysine levels increases by 1 unit of pg/mg of albumin, after controlling for potential confounders. Among a nonrandom set of infants who had measurements for placental weight, haemoglobin at delivery, and follow-up z-score measurements, we find no association between aflatoxin plasma concentrations and these variables. These findings suggest a high prevalence of chronic low-level exposure to aflatoxin, though its effect on birth outcomes in this population remains unclear. Our research adds to a growing body of literature finding mixed associations between aflatoxins on pregnancy outcomes and child growth.
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References34
Newest
#1Johanna Y Andrews-Trevino (Tufts University)
#2Patrick Webb (Tufts University)H-Index: 32
Last. Shibani Ghosh (Tufts University)H-Index: 10
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#1Vivian Hoffmann (IFPRI: International Food Policy Research Institute)H-Index: 10
#2Kelly Jones (AU: American University)H-Index: 1
Last. Jef L. Leroy (IFPRI: International Food Policy Research Institute)H-Index: 20
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Introduction Observational studies have documented an association between aflatoxin (AF) exposure and reduced linear growth in infants and young children. Our objective was to assess the effectiveness of reducing AF exposure on child linear growth and serum AF levels in rural areas in Eastern Kenya. Methods A cluster randomised controlled design was used (28 intervention and 28 control clusters). The intervention arm received a swapping (contaminated maize was replaced with safe maize) and a sto...
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#1Sinead Watson ('QUB': Queen's University Belfast)H-Index: 4
#2Sophie E. Moore ('KCL': King's College London)H-Index: 40
Last. Yun Yun Gong (University of Leeds)H-Index: 27
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Exposure to aflatoxin, a mycotoxin produced by fungi that commonly contaminates cereal crops across sub-Saharan Africa, has been associated with impaired child growth. We investigated the impact of aflatoxin exposure on the growth of Gambian infants from birth to two years of age, and the impact on insulin-like growth factor (IGF)-axis proteins. A subsample (N = 374) of infants from the Early Nutrition and Immune Development (ENID) trial (ISRCTN49285450) were included in this study. Aflatoxin-al...
4 CitationsSource
#1Jef L. Leroy (IFPRI: International Food Policy Research Institute)H-Index: 20
#2Celeste Sununtnasuk (IFPRI: International Food Policy Research Institute)H-Index: 5
Last. Jia-Sheng Wang (UGA: University of Georgia)H-Index: 1
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#1Chen Chen (MSU: Michigan State University)H-Index: 4
#2Nicole J. Mitchell (MSU: Michigan State University)H-Index: 7
Last. Felicia Wu (MSU: Michigan State University)H-Index: 29
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12 CitationsSource
#1Laura E. Smith (Cornell University)H-Index: 10
#2Andrew J. Prendergast (Johns Hopkins University)H-Index: 33
Last. Rebecca J. Stoltzfus (Cornell University)H-Index: 54
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Pregnant women and their developing fetuses are vulnerable to multiple environmental insults, including exposure to aflatoxin, a mycotoxin that may contaminate as much as 25% of the world food supply. We reviewed and integrated findings from studies of aflatoxin exposure during pregnancy and evaluated potential links to adverse pregnancy outcomes. We identified 27 studies (10 human cross‐sectional studies and 17 animal studies) assessing the relationship between aflatoxin exposure and adverse bi...
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#1Jef L. Leroy (IFPRI: International Food Policy Research Institute)H-Index: 20
#2Jia-Sheng Wang (UGA: University of Georgia)H-Index: 1
Last. Kelly M. Jones (IFPRI: International Food Policy Research Institute)H-Index: 5
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Notwithstanding the growing concern about the negative impact of aflatoxin (AF) on human health, there is a dearth of evidence on the socio-economic determinants of AF exposure in low and middle income countries.
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#1Analee J. Etheredge (Harvard University)H-Index: 7
#2Zul Premji (MUHAS: Muhimbili University of Health and Allied Sciences)H-Index: 35
Last. Wafaie W. Fawzi (Harvard University)H-Index: 65
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−0.7 g/dL, P < .001) and serum ferritin (41.3 vs 11.3 μg/L, P < .001). Iron supplementation significantly decreased the risk of anemia at delivery by 40% (RR, 0.60; 95% CI, 0.51-0.71) but not severe anemia (RR, 0.68; 95% CI, 0.41-1.14). Iron supplementation significantly reduced the risk of maternal iron deficiency at delivery by 52% (RR, 0.48; 95% CI, 0.32-0.70) and the risk of iron deficiency anemia by 66% (RR, 0.34; 95% CI, 0.19-0.62). CONCLUSIONS AND RELEVANCE Prenatal iron supplementation a...
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#2Sándor Kocsubé (University of Szeged)H-Index: 24
Last. János Varga (University of Szeged)H-Index: 51
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Aflatoxins are the most important mycotoxins produced predominantly by certain strains whithin species of the Aspergillus genus. Aflatoxin contamination of foods and feeds causes serious economic and health problem worldwide. Aflatoxin B1 exhibits hepatocarcinogenic and hepatotoxic properties, and it is the most potent naturally occurring carcinogen. Climate change has led to the presence of aflatoxin producing species, especially A. flavus and consequently aflatoxin contamination, in areas wher...
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#1Min su Kang (UGA: University of Georgia)H-Index: 2
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Aflatoxins (AF) are a group of mycotoxins. AF exposure causes acute and chronic adverse health effects such as aflatoxicosis and hepatocellular carcinoma in human populations, especially in the developing world. In this study, AF exposure was evaluated using archived serum samples from human immunodeficiency virus (HIV)-seronegative participants from two cohort studies in south-western Uganda. AFB1–lysine (AFB-Lys) adduct levels were determined via HPLC fluorescence in a total of 713 serum sampl...
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