Multiple mycotoxin exposure during pregnancy and risks of adverse birth outcomes: a prospective cohort study in rural Ethiopia

Kokeb Tesfamariam; Alemayehu Argaw; Giles T Hanley-Cook; Seifu H Gebreyesus; Patrick Kolsteren; Tefera Belachew; Mario Van de Velde; Sarah De Saeger; Marthe De Boevre; Carl Lachat

doi:10.1016/j.envint.2021.107052

Multiple mycotoxin exposure during pregnancy and risks of adverse birth outcomes: a prospective cohort study in rural Ethiopia

Environ Int. 2022 Feb:160:107052. doi: 10.1016/j.envint.2021.107052. Epub 2021 Dec 21.

Authors

Affiliations

¹ Department of Food Technology, Safety and Health, Faculty of Bioscience Engineering, Ghent University, Ghent, Belgium; Department of Public Health, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia; Center of Excellence in Mycotoxicology and Public Health, Faculty of Pharmaceutical Sciences, Ghent University, MYTOX-SOUTH® Coordination Unit, Ghent, Belgium; Department of Population and Family Health, Institute of Health, Jimma University, Jimma, Ethiopia.
² Department of Food Technology, Safety and Health, Faculty of Bioscience Engineering, Ghent University, Ghent, Belgium; Department of Population and Family Health, Institute of Health, Jimma University, Jimma, Ethiopia.
³ Department of Food Technology, Safety and Health, Faculty of Bioscience Engineering, Ghent University, Ghent, Belgium.
⁴ Department of Nutrition and Dietetics, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
⁵ Department of Population and Family Health, Institute of Health, Jimma University, Jimma, Ethiopia.
⁶ Center of Excellence in Mycotoxicology and Public Health, Faculty of Pharmaceutical Sciences, Ghent University, MYTOX-SOUTH® Coordination Unit, Ghent, Belgium.
⁷ Center of Excellence in Mycotoxicology and Public Health, Faculty of Pharmaceutical Sciences, Ghent University, MYTOX-SOUTH® Coordination Unit, Ghent, Belgium; Department of Biotechnology and Food Technology, Faculty of Science, University of Johannesburg, Doornfontein Campus, Gauteng, South Africa.
⁸ Department of Food Technology, Safety and Health, Faculty of Bioscience Engineering, Ghent University, Ghent, Belgium. Electronic address: Carl.Lachat@ugent.be.

PMID: 34952355
DOI: 10.1016/j.envint.2021.107052

Abstract

Introduction: Mycotoxin exposure during pregnancy has been associated with adverse birth outcomes in low- and middle-income countries. The evidence, however, is inconsistent and mainly limited to the assessment of a single mycotoxin. We assessed biomarkers of exposure to multiple mycotoxins during pregnancy and their associations with adverse birth outcomes in rural Ethiopia.

Methods: We analyzed data from 579 pregnant women between 8 and 24 weeks of completed gestation enrolled in a prospective cohort study. Serum mycotoxin concentrations were determined using liquid chromatography coupled with tandem mass spectrometry. Multivariable linear probability models, adjusted for potential confounding factors and multiple comparisons, were fitted to assess the associations between mycotoxin exposure and small for gestational age and preterm birth. We applied principal component analysis to reduce the dimensionality of biomarker data from several taxonomic mycotoxin groups.

Results: All pregnant women were co-exposed to at least five mycotoxins, and one pregnant woman was co-exposed to 27 mycotoxins. Fumonisins (FB), i.e., FB₂, FB₃, FB₁, and tenuazonic acid were the most frequently identified mycotoxins in 98.8, 95.3, 93.3, and 81.4% of the samples respectively. Deoxynivalenol was detected in 38.7%, nivalenol in 50.1%, ochratoxin α in 67.9%, and zearalenone in 50.9% of the serum samples. After adjustment, we found no statistically significant (all P ≥ 0.05) associations between mycotoxin exposures and birth outcomes.

Conclusions: Despite our study providing no evidence for relationships between mycotoxin biomarkers and adverse birth outcomes, our findings do indicate an extensive presence of multiple mycotoxin exposure among pregnant women. Public health policies and nutrition-sensitive interventions must ensure exposure to mycotoxins is reduced in rural Ethiopia.

Keywords: Biomarkers; Birth outcomes; Ethiopia; Mycotoxins; Pregnancy.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Ethiopia / epidemiology
Female
Food Contamination / analysis
Humans
Infant, Newborn
Mycotoxins* / adverse effects
Pregnancy
Premature Birth* / epidemiology
Prospective Studies

Substances

Mycotoxins