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Aflatoxin exposure in pregnant women of mixed status of human immunodeficiency virus infection and rate of gestational weight gain: a Ugandan cohort study.
Trop Med Int Health. 2020 Jul 04 [Online ahead of print]TM

Abstract

OBJECTIVES

To examine the association between aflatoxin (AF) exposure during pregnancy and rate of gestational weight gain (GWG) in a sample of pregnant women of mixed HIV status in Gulu, northern Uganda.

METHODS

403 pregnant women were included (133 HIV-infected on antiretroviral therapy (ART), 270 HIV-uninfected). Women's weight, height and socio-demographic characteristics were collected at baseline (~19 weeks' gestation); weight was assessed at each follow-up visit. Serum was collected at baseline and tested for aflatoxin B1 -lysine adduct (AFB-lys) levels using high-performance liquid chromatography (HPLC). Linear mixed-effects models were used to examine the association between AFB-lys levels and rate of GWG.

RESULTS

AFB-lys levels (detected in 98.3% of samples) were higher among HIV-infected pregnant women than HIV-uninfected pregnant women [median (interquartile range): 4.8 (2.0, 15.0) vs. 3.5 (1.6, 6.1) pg/mg of albumin, P < 0.0001]. Adjusting for HIV status, a one-log increase in aflatoxin levels was associated with a 16.2 g per week lower rate of GWG (P = 0.028). The association between AFB-lys and the rate of GWG was stronger and significant only among HIV-infected women on ART [-25.7 g per week per log (AFB-lys), P = 0.009 for HIV-infected women vs. -7.5 g per week per log (AFB-lys), P = 0.422 for HIV-uninfected women].

CONCLUSIONS

Pregnant women with higher levels of AF exposure had lower rates of GWG. The association was stronger for HIV-infected women on ART, suggesting increased risk.

Authors+Show Affiliations

Division of Gastroenterology, Hepatology and Nutrition, Boston Children's Hospital, Boston, MA, USA. Feed the Future Innovation Lab for Nutrition, Tufts University, Boston, MA, USA.MRC/UVRI and LSHTM Uganda Research Unit, Noncommunicable Diseases Theme, Entebbe, Uganda.Feed the Future Innovation Lab for Nutrition, Tufts University, Boston, MA, USA. Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA.Feed the Future Innovation Lab for Nutrition, Tufts University, Boston, MA, USA. Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA.Department of Environmental Health Science, University of Georgia, Athens, GA, USA.Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA. Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32623795

Citation

Lauer, Jacqueline M., et al. "Aflatoxin Exposure in Pregnant Women of Mixed Status of Human Immunodeficiency Virus Infection and Rate of Gestational Weight Gain: a Ugandan Cohort Study." Tropical Medicine & International Health : TM & IH, 2020.
Lauer JM, Natamba BK, Ghosh S, et al. Aflatoxin exposure in pregnant women of mixed status of human immunodeficiency virus infection and rate of gestational weight gain: a Ugandan cohort study. Trop Med Int Health. 2020.
Lauer, J. M., Natamba, B. K., Ghosh, S., Webb, P., Wang, J. S., & Griffiths, J. K. (2020). Aflatoxin exposure in pregnant women of mixed status of human immunodeficiency virus infection and rate of gestational weight gain: a Ugandan cohort study. Tropical Medicine & International Health : TM & IH. https://doi.org/10.1111/tmi.13457
Lauer JM, et al. Aflatoxin Exposure in Pregnant Women of Mixed Status of Human Immunodeficiency Virus Infection and Rate of Gestational Weight Gain: a Ugandan Cohort Study. Trop Med Int Health. 2020 Jul 4; PubMed PMID: 32623795.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Aflatoxin exposure in pregnant women of mixed status of human immunodeficiency virus infection and rate of gestational weight gain: a Ugandan cohort study. AU - Lauer,Jacqueline M, AU - Natamba,Barnabas K, AU - Ghosh,Shibani, AU - Webb,Patrick, AU - Wang,Jia-Sheng, AU - Griffiths,Jeffrey K, Y1 - 2020/07/04/ PY - 2020/7/6/pubmed PY - 2020/7/6/medline PY - 2020/7/6/entrez KW - HIV KW - Uganda KW - aflatoxin KW - pregnancy outcomes JF - Tropical medicine & international health : TM & IH JO - Trop. Med. Int. Health N2 - OBJECTIVES: To examine the association between aflatoxin (AF) exposure during pregnancy and rate of gestational weight gain (GWG) in a sample of pregnant women of mixed HIV status in Gulu, northern Uganda. METHODS: 403 pregnant women were included (133 HIV-infected on antiretroviral therapy (ART), 270 HIV-uninfected). Women's weight, height and socio-demographic characteristics were collected at baseline (~19 weeks' gestation); weight was assessed at each follow-up visit. Serum was collected at baseline and tested for aflatoxin B1 -lysine adduct (AFB-lys) levels using high-performance liquid chromatography (HPLC). Linear mixed-effects models were used to examine the association between AFB-lys levels and rate of GWG. RESULTS: AFB-lys levels (detected in 98.3% of samples) were higher among HIV-infected pregnant women than HIV-uninfected pregnant women [median (interquartile range): 4.8 (2.0, 15.0) vs. 3.5 (1.6, 6.1) pg/mg of albumin, P < 0.0001]. Adjusting for HIV status, a one-log increase in aflatoxin levels was associated with a 16.2 g per week lower rate of GWG (P = 0.028). The association between AFB-lys and the rate of GWG was stronger and significant only among HIV-infected women on ART [-25.7 g per week per log (AFB-lys), P = 0.009 for HIV-infected women vs. -7.5 g per week per log (AFB-lys), P = 0.422 for HIV-uninfected women]. CONCLUSIONS: Pregnant women with higher levels of AF exposure had lower rates of GWG. The association was stronger for HIV-infected women on ART, suggesting increased risk. SN - 1365-3156 UR - https://www.unboundmedicine.com/medline/citation/32623795/Aflatoxin_exposure_in_pregnant_women_of_mixed_status_of_human_immunodeficiency_virus_infection_and_rate_of_gestational_weight_gain:_a_Ugandan_cohort_study L2 - https://doi.org/10.1111/tmi.13457 DB - PRIME DP - Unbound Medicine ER -
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