Maternal exposure to multiple mycotoxins and adverse pregnancy outcomes: a prospective cohort study in rural Bangladesh

Abstract

There is limited and inconsistent evidence, primarily from cross-sectional studies, linking mycotoxins to adverse birth outcomes. This study investigates the potential role of maternal dietary exposure to multiple mycotoxins in the development of several adverse pregnancy and birth outcomes. We analyzed data from 436 singleton pregnancies enrolled in a prospective cohort study in the rural Habiganj district, Bangladesh, between July 2018 and November 2019. Thirty-five urinary mycotoxin biomarkers were quantified using liquid chromatography coupled with tandem mass spectrometry and used to estimate dietary mycotoxin exposure. Multivariable regression models, adjusted for potential confounding and clustering, were fitted to assess the associations between maternal exposure to frequently occurring mycotoxins (ochratoxin A-OTA, citrinin- CIT, and Deoxynivalenol- DON) and pregnancy loss, preterm birth (PTB), low birth weight (LBW), born small-for-gestational-age (SGA) and small-vulnerable newborn. The results indicate that only in 16 of 436 pregnancies (4%) were urine samples free from all investigated mycotoxins. Biomarkers for six major mycotoxins were detected in the urine samples. OTA (95%), CIT (61%), and DON (6%) were most frequently detected, with at least two mycotoxins co-occurring in the majority of women (63%). There was evidence that maternal dietary intake of OTA was associated with higher odds of having an LBW baby, with the odds increasing in a dose-dependent manner. We found no evidence of associations between pregnancy loss, PTB, SGA, small-vulnerable newborns, and maternal dietary exposure to OTA, CIT, and DON, albeit with large confidence intervals, so findings are consistent with protective as well as large harmful effects. Exposure to multiple mycotoxins during pregnancy is widespread in this rural community and represents a health risk for mothers and babies. Tailored public health policies and interventions must be implemented to reduce mycotoxin exposure to the lowest possible level.

Adverse associations between maternal deoxynivalenol exposure and birth outcomes: a prospective cohort study in China

“…Pregnant women may be exposed to multiple mycotoxins simultaneously by dietary, since similar environmental conditions could produce several mycotoxins in foods at the same time [ 46 ]. Although a cohort study in Bangladesh reported that maternal dietary intake of ochratoxin A was associated with higher risk of having an LBW baby, it did not find a difference between exposure alone and combined exposure to other mycotoxins [ 47 ]. Therefore, further epidemiological studies are needed to evaluate the complex effects of co-exposure of mycotoxins on the health risk in pregnant women.…”

Integrating a Multiple Isotopologue Reaction-Monitoring Technique and LC-MS/MS for Quantitation of Small Molecules: Ten Mycotoxins in Cereals as an Example

“…5 However, the co-occurrence of multiple mycotoxins in cereals presents a complex challenge due to potential interactions among these compounds. 3,9 Thus, developing a reliable and robust method for accurately quantifying multiple mycotoxins in cereals holds paramount significance. 2,4 Over the past two decades, liquid chromatography coupled with triple quadrupole mass spectrometry (LC-MS/MS) and high-resolution mass spectrometry have attracted widespread popularity for mycotoxin determination due to their inherent specificity, sensitivity, and accuracy.…”

“…The trichothecenes encompass a substantial array of mycotoxins, where deoxynivalenol (DON) and zearalenone (ZEN) are the most commonly contaminated in harvested products such as maize and wheat. ,, In light of the widespread contamination and toxicity of mycotoxins in cereals, feeds, and other consumables, stringent limits for the major mycotoxins in grains have been established by many countries . However, the co-occurrence of multiple mycotoxins in cereals presents a complex challenge due to potential interactions among these compounds. , Thus, developing a reliable and robust method for accurately quantifying multiple mycotoxins in cereals holds paramount significance. , …”

Prenatal Fumonisin Exposure Impairs Bone Development via Disturbances in the OC/Leptin and RANKL/RANK/OPG Systems in Weaned Rat Offspring

“…Humans are unknowingly exposed to FBs through food intake due to mycotoxins are difficult to monitor continuously, and a tools to assess the risk are poor [42][43][44]. Prenatal FBs exposure results not only in altered prenatal development, disturbances in the structure and function of bone and the gastrointestinal tract (liver, intestine, including enteric nervous system), impaired hematopoiesis and inflammation in skeletal muscles, it also leads to endocrine alterations resulting in disproportional development and increased risk of diabetes mellitus [12,37,[45][46][47][48][49][50][51]. Considering FBs-exposure results in various health problems, including imbalances in the collagenous and non-collagenous bone proteins involved in bone turnover, it seems reasonable to further investigate the effects of prenatal FBs exposure on bone metabolism, which is important in the development of the whole organism and its functioning.…”