Association between Anemia and Aflatoxin B1 Biomarker Levels among Pregnant Women in Kumasi, Ghana

Shuaib, Faisal; Jolly, Pauline E.; Ehiri, John E.; Jiang, Yi; Ellis, William O.; Stiles, Jonathan K.; Yatich, Nelly; Funkhouser, Ellen; Person, Sharina D.; Wilson, C. Garrett; Williams, Jonathan

doi:10.4269/ajtmh.2010.09-0772

Cited by 53 publications

(42 citation statements)

References 22 publications

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“…Shuaib and others9 reported a cross-sectional association between AF-alb and anemia in 785 pregnant Ghanaian women, with those in the highest quartile of aflatoxin exposure having 1.85-fold increased odds of anemia compared with those in the lowest quartile (confidence interval = 1.16–2.85).…”

Section: Methodsmentioning

confidence: 99%

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Aflatoxin Exposure During Pregnancy, Maternal Anemia, and Adverse Birth Outcomes

Smith

Prendergast

Turner

et al. 2017

The American Journal of Tropical Medicine and Hygiene

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Pregnant women and their developing fetuses are vulnerable to multiple environmental insults, including exposure to aflatoxin, a mycotoxin that may contaminate as much as 25% of the world food supply. We reviewed and integrated findings from studies of aflatoxin exposure during pregnancy and evaluated potential links to adverse pregnancy outcomes. We identified 27 studies (10 human cross-sectional studies and 17 animal studies) assessing the relationship between aflatoxin exposure and adverse birth outcomes or anemia. Findings suggest that aflatoxin exposure during pregnancy may impair fetal growth. Only one human study investigated aflatoxin exposure and prematurity, and no studies investigated its relationship with pregnancy loss, but animal studies suggest aflatoxin exposure may increase risk for prematurity and pregnancy loss. The fetus could be affected by maternal aflatoxin exposure through direct toxicity as well as indirect toxicity, via maternal systemic inflammation, impaired placental growth, or elevation of placental cytokines. The cytotoxic and systemic effects of aflatoxin could plausibly mediate maternal anemia, intrauterine growth restriction, fetal loss, and preterm birth. Given the widespread exposure to this toxin in developing countries, longitudinal studies in pregnant women are needed to provide stronger evidence for the role of aflatoxin in adverse pregnancy outcomes, and to explore biological mechanisms. Potential pathways for intervention to reduce aflatoxin exposure are urgently needed, and this might reduce the global burden of stillbirth, preterm birth, and low birthweight.

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Section: Methodsmentioning

confidence: 99%

“…Aflatoxins have been most widely studied as causative agents of liver cancer 7. Chronic exposure has also been associated with other adverse human health outcomes, including growth faltering8 and maternal anemia 9. Exposure during pregnancy has been widely documented,10,11 but the effects on the mother and fetus are not well described.…”

Section: Introductionmentioning

confidence: 99%

Aflatoxin Exposure During Pregnancy, Maternal Anemia, and Adverse Birth Outcomes

Smith

Prendergast

Turner

et al. 2017

The American Journal of Tropical Medicine and Hygiene

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“…Also, rural populations suffer poverty more frequently than urban populations in Uganda (Mukwaya et al 2012). The association of AF exposure with poverty has been well proven (Shuaib et al 2012;Adejumo et al 2013).…”

Section: Round (Year)mentioning

confidence: 99%

Longitudinal evaluation of aflatoxin exposure in two cohorts in south-western Uganda

Kang

Nkurunziza

Muwanika

et al. 2015

Food Additives & Contaminants: Part A

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akes every effort t o ensure t he accuracy of all t he inform at ion ( t he " Cont ent " ) cont ained in t he publicat ions on our plat form . However, Taylor & Francis, our agent s, and our licensors m ake no represent at ions or warrant ies what soever as t o t he accuracy, com plet eness, or suit abilit y for any purpose of t he Cont ent . Any opinions and views expressed in t his publicat ion are t he opinions and views of t he aut hors, and are not t he views of or endorsed by Taylor & Francis. The accuracy of t he Cont ent should not be relied upon and should be independent ly verified wit h prim ary sources of inform at ion. Taylor and Francis shall not be liable for any losses, act ions, claim s, proceedings, dem ands, cost s, expenses, dam ages, and ot her liabilit ies what soever or howsoever caused arising direct ly or indirect ly in connect ion wit h, in relat ion t o or arising out of t he use of t he Cont ent . This art icle m ay be used for research, t eaching, and privat e st udy purposes. Any subst ant ial or syst em at ic reproduct ion, redist ribut ion, reselling, loan, sub-licensing, syst em at ic supply, or dist ribut ion in any form t o anyone is expressly forbidden. Term s & Condit ions of access and use can be found at ht t p: / / www.t andfonline.com / page/ t erm s-and-condit ions Aflatoxins (AF) are a group of mycotoxins. AF exposure causes acute and chronic adverse health effects such as aflatoxicosis and hepatocellular carcinoma in human populations, especially in the developing world. In this study, AF exposure was evaluated using archived serum samples from human immunodeficiency virus (HIV)-seronegative participants from two cohort studies in south-western Uganda. AFB 1 -lysine (AFB-Lys) adduct levels were determined via HPLC fluorescence in a total of 713 serum samples from the General Population Cohort (GPC), covering eight time periods between 1989 and 2010. Overall, 90% (642/713) of the samples were positive for AFB-Lys and the median level was 1.58 pg mg −1 albumin (range = 0.40-168 pg mg −1 albumin). AFB-Lys adduct levels were also measured in a total of 374 serum samples from the Rakai Community Cohort Study (RCCS), across four time periods between 1999 and 2003. The averaged detection rate was 92.5% (346/374) and the median level was 1.18 pg mg −1 albumin (range = 0.40-122.5 pg mg −1 albumin). In the GPC study there were no statistically significant differences between demographic parameters, such as age, sex and level of education, and levels of serum AFB-Lys adduct. In the RCCS study, longitudinal analysis using generalised estimating equations revealed significant differences between the adduct levels and residential areas (p = 0.05) and occupations (p = 0.02). This study indicates that AF exposure in people in two populations in south-western Uganda is persistent and has not significantly changed over time. Data from one study, but not the other, indicated that agriculture workers and rural area residents had more AF exposure than those non-agricultural workers and non...

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“…It has been reported that there is a relationship between the maternal blood AFB 1 level and development of maternal anemia and following fetal hypoxia as demonstrated in pregnant women in Ghana (Shuaib et al, 2010). Experimentally, it is reported that chronic hypoxia impairs brain development and hippocampal neurogenesis involving reduced proliferation of granule cell lineages and reduced brain weight and hippocampal volume in suckling rats (Raman et al, 2011).…”

Section: Discussionmentioning

confidence: 97%

Developmental exposure of aflatoxin B1 reversibly affects hippocampal neurogenesis targeting late-stage neural progenitor cells through suppression of cholinergic signaling in rats

Tanaka¹,

Mizukami²,

Hasegawa-Baba³

et al. 2015

Toxicology

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Association between Anemia and Aflatoxin B1 Biomarker Levels among Pregnant Women in Kumasi, Ghana

Cited by 53 publications

References 22 publications

Aflatoxin Exposure During Pregnancy, Maternal Anemia, and Adverse Birth Outcomes

Aflatoxin Exposure During Pregnancy, Maternal Anemia, and Adverse Birth Outcomes

Longitudinal evaluation of aflatoxin exposure in two cohorts in south-western Uganda

Developmental exposure of aflatoxin B1 reversibly affects hippocampal neurogenesis targeting late-stage neural progenitor cells through suppression of cholinergic signaling in rats

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