Ochratoxin A Status at Birth Is Associated with Reduced Birth Weight and Ponderal Index in Rural Burkina Faso

Abstract

Background: Mycotoxin exposure during pregnancy has been associated with adverse birth outcomes and poor infant growth. We assessed multiple biomarkers and metabolites of exposure to mycotoxins at birth and their associations with birth outcomes and infant growth in 274 newborns in rural Burkina Faso.

Methods: Whole-blood microsamples were analyzed for mycotoxin concentrations in newborns in the Biospecimen substudy nested in the MIcronutriments pour la SAnté de la Mère et de l'Enfant-III trial using ultra-performance liquid chromatography coupled with tandem mass spectrometry. Unadjusted and adjusted associations between mycotoxin exposure, and birth outcomes and infant growth at 6 mo were estimated using linear regression models for continuous outcomes and linear probability models with robust variance estimation for binary outcomes. Infant growth trajectories from birth to 6 mo were compared by exposure status using mixed-effects models with a random intercept for the individual infant and a random slope for the infant's age.

Results: Ochratoxin A (OTA) exposure was detected in 38.3% of newborns, with other mycotoxins being detected in the range of 0.36% and 4.01%. OTA exposure was significantly associated with adverse birth outcomes, such as lower birth weight [β (95% CI): -0.11 kg (-0.21, 0.00); P = 0.042] and ponderal index [β (95% CI): -0.62 gm/cm³ (-1.19, -0.05); P = 0.034], and a marginally significant lower length growth trajectories during the first 6 mo [β (95% CI): -0.08 cm/mo (-0.15, 0.0); P = 0.057].

Conclusions: OTA exposure was prevalent among newborns and also associated with lower growth at birth and during the first 6 mo. The results emphasize the importance of nutrition-sensitive strategies to mitigate dietary OTA, as well as adopting food safety measures in Burkina Faso during the fetal period of development.

Keywords: MISAME-III; birth outcomes; exposomics; growth; low- and middle-income countries; mycotoxins; ochratoxin A; sub-Saharan Africa.

FIGURE 1

Study flow diagram of the Biospecimen sub-study (BioSpé) of the MISAME-III project. MISAME-III; MIcronutriments pour la SAnté de la Mère et de l’Enfant III.

FIGURE 2

Infant growth trajectories from birth to 6 mo in OTA unexposed (solid lines; n = 169) and exposed (dashed lines; n = 105) groups. Mixed-effects models with a random intercept for the individual infant and random slope for the child age were fitted to compare OTA-exposed and unexposed groups by growth trajectories during the first 6-mo postpartum. Quadratic models were used for the outcomes height, weight, and MUAC, and a restricted cubic spline model with 4 knots for the outcome head circumference. Fixed effects in the models contained the main effect of time, OTA exposure status, and time-by-exposure interaction, which the later evaluates the difference in monthly growth trajectories between exposed and unexposed groups. Additional covariates in the models included the health center catchment areas, the prenatal and postnatal interventions allocation, maternal age, primiparity, baseline BMI and hemoglobin concentration, household size, wealth index score, access to improved water and sanitation, and food security status. Abbreviations: MUAC, mid-upper arm circumference; OTA, ochratoxin A.