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

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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 a 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
General Environmental Science, Mycotoxins, Biomarkers, Birth outcomes, Pregnancy, Ethiopia, FOR-GESTATIONAL-AGE, NEURAL-TUBE DEFECTS, AFLATOXIN EXPOSURE, PRETERM BIRTH, GROWTH, FUMONISINS, HEALTH, DEOXYNIVALENOL, ASSOCIATION, CONSUMPTION

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MLA
Hadush, Kokeb Tesfamariam, et al. “Multiple Mycotoxin Exposure during Pregnancy and Risks of Adverse Birth Outcomes : A Prospective Cohort Study in Rural Ethiopia.” ENVIRONMENT INTERNATIONAL, vol. 160, 2022, doi:10.1016/j.envint.2021.107052.
APA
Hadush, K. T., Argaw, A., Hanley-Cook, G., Gebreyesus, S. H., Kolsteren, P., Belachew, T., … Lachat, C. (2022). Multiple mycotoxin exposure during pregnancy and risks of adverse birth outcomes : a prospective cohort study in rural Ethiopia. ENVIRONMENT INTERNATIONAL, 160. https://doi.org/10.1016/j.envint.2021.107052
Chicago author-date
Hadush, Kokeb Tesfamariam, Alemayehu Argaw, Giles Hanley-Cook, Seifu H. Gebreyesus, Patrick Kolsteren, Tefera Belachew, Mario Van de Velde, Sarah De Saeger, Marthe De Boevre, and Carl Lachat. 2022. “Multiple Mycotoxin Exposure during Pregnancy and Risks of Adverse Birth Outcomes : A Prospective Cohort Study in Rural Ethiopia.” ENVIRONMENT INTERNATIONAL 160. https://doi.org/10.1016/j.envint.2021.107052.
Chicago author-date (all authors)
Hadush, Kokeb Tesfamariam, Alemayehu Argaw, Giles Hanley-Cook, Seifu H. Gebreyesus, Patrick Kolsteren, Tefera Belachew, Mario Van de Velde, Sarah De Saeger, Marthe De Boevre, and Carl Lachat. 2022. “Multiple Mycotoxin Exposure during Pregnancy and Risks of Adverse Birth Outcomes : A Prospective Cohort Study in Rural Ethiopia.” ENVIRONMENT INTERNATIONAL 160. doi:10.1016/j.envint.2021.107052.
Vancouver
1.
Hadush KT, Argaw A, Hanley-Cook G, Gebreyesus SH, Kolsteren P, Belachew T, et al. Multiple mycotoxin exposure during pregnancy and risks of adverse birth outcomes : a prospective cohort study in rural Ethiopia. ENVIRONMENT INTERNATIONAL. 2022;160.
IEEE
[1]
K. T. Hadush et al., “Multiple mycotoxin exposure during pregnancy and risks of adverse birth outcomes : a prospective cohort study in rural Ethiopia,” ENVIRONMENT INTERNATIONAL, vol. 160, 2022.
@article{8731940,
  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 a 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.}},
  articleno    = {{107052}},
  author       = {{Hadush, Kokeb Tesfamariam and Argaw, Alemayehu and Hanley-Cook, Giles and Gebreyesus, Seifu H. and Kolsteren, Patrick and Belachew, Tefera and Van de Velde, Mario and De Saeger, Sarah and De Boevre, Marthe and Lachat, Carl}},
  issn         = {{0160-4120}},
  journal      = {{ENVIRONMENT INTERNATIONAL}},
  keywords     = {{General Environmental Science,Mycotoxins,Biomarkers,Birth outcomes,Pregnancy,Ethiopia,FOR-GESTATIONAL-AGE,NEURAL-TUBE DEFECTS,AFLATOXIN EXPOSURE,PRETERM BIRTH,GROWTH,FUMONISINS,HEALTH,DEOXYNIVALENOL,ASSOCIATION,CONSUMPTION}},
  language     = {{eng}},
  pages        = {{10}},
  title        = {{Multiple mycotoxin exposure during pregnancy and risks of adverse birth outcomes : a prospective cohort study in rural Ethiopia}},
  url          = {{http://dx.doi.org/10.1016/j.envint.2021.107052}},
  volume       = {{160}},
  year         = {{2022}},
}

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