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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.

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.

SUBMITTER: Lauer JM

PROVIDER: S-EPMC7539974 | biostudies-literature | 2020 Jul

REPOSITORIES: biostudies-literature

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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.

Lauer Jacqueline M JM Natamba Barnabas K BK Ghosh Shibani S Webb Patrick P Wang Jia-Sheng JS Griffiths Jeffrey K JK

Tropical medicine & international health : TM & IH 20200726 9

<h4>Objectives</h4>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.<h4>Methods</h4>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 ...[more]

PMID: 32623795

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Project description:Background:Excessive gestational weight gain and rapid infancy weight gain (RIWG) are associated with increased susceptibility to childhood obesity. Since low-income and minority children are particularly at risk, investigation of the associations between gestational weight gain and rate of infancy weight gain may inform childhood obesity prevention. This study investigated the associations between gestational weight gain and rate of infancy weight gain during the first four to six months postpartum in participants from the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) in Hawai'i and Puerto Rico. Methods:This was a cross-sectional secondary data analysis from a text message-based intervention in WIC participants in Hawai'i and Puerto Rico. The analysis included 80 mother/infant pairs from the control group who completed the follow-up visit when infants were four to six months old. Maternal weight, height, and gestational weight gain were self-reported. Infant weight was measured at baseline and follow-up. A proportional odds model was used to investigate the association between gestational weight gain and infancy weight gain rate (rapid or extremely rapid, on-track, or slow), adjusting for maternal age, pregravid body mass index (BMI) status, parity, and being up-to-date with infant vaccinations. Results:In comparison to recommended gestational weight gain, excessive and inadequate (under the recommended amount) gestational weight gain was associated with 77% decreased (adjusted odds ratio [AOR]?=?0.23; 95% confidence interval [CI]?=?0.08, 0.70; p?=?0.01) and 71% decreased (AOR?=?0.29; 95% CI?=?0.09, 0.94; p?=?0.04) odds of RIWG versus on-track or slow infant weight gain, respectively. In comparison to women with one child, women with two children (AOR?=?0.31; 95% CI?=?0.11, 0.87; p?=?0.03) or three or four children (AOR?=?0.24; 95% CI?=?0.07, 0.88; p?=?0.03) had significantly lower odds of RIWG versus on-track or slow infancy weight gain. Conclusions:Women with excessive or inadequate gestational weight gain had lower proportional odds of RIWG and were more likely to have slower infant weight gain than women who gained the recommended amount of weight. Trial registration:ClinicalTrials.gov Identifier; NCT02903186; September 16, 2016.

Project description:During pregnancy, many women gain excessive weight, which is related to adverse maternal and neonatal outcomes. In this study, we evaluated whether rate of gestational weight gain (RGWG) in early, mid, and late pregnancy is strongly associated with adverse pregnancy outcomes. A retrospective chart review of 2,789 pregnant Korean women was performed. Weights were recorded at the first clinic visit, during the screening test for fetal anomaly, and during the 50g oral glucose challenge test and delivery, to represent early, mid, and late pregnancy, respectively. A multivariate logistic regression analysis was performed to examine the relationship between RGWG and adverse pregnancy outcomes. At early pregnancy, the RGWG was significantly associated with high risk of developing gestational diabetes mellitus (GDM), pregnancy-induced hypertension (PIH), large for gestational age (LGA) infants, macrosomia, and primary cesarean section (P-CS). The RGWG of mid pregnancy was not significantly associated with any adverse pregnancy outcomes. The RGWG at late pregnancy was significantly associated with a lower risk of developing GDM, preterm birth and P-CS, but with a higher risk of developing LGA infants and macrosomia. When the subjects were divided into three groups (Underweight, Normal, and Obese), based on pre-pregnancy body mass index (BMI), the relationship between early RGWG and adverse pregnancy outcomes was significantly different across the three BMI groups. At early pregnancy, RGWG was not significantly associated to adverse pregnancy outcomes for subjects in the Underweight group. In the Normal group, however, early RGWG was significantly associated with GDM, PIH, LGA infants, macrosomia, P-CS, and small for gestational weight (SGA) infants, whereas early RGWG was significantly associated with only a high risk of PIH in the Obese group. The results of our study suggest that early RGWG is significantly associated with various adverse pregnancy outcomes and that proper preemptive management of early weight gain, particularly in pregnant women with a normal or obese pre-pregnancy BMI, is necessary to reduce the risk of developing adverse pregnancy outcomes.

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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.

Publications

Aflatoxin exposure in pregnant women of mixed status of human immunodeficiency virus infection and rate of gestational weight gain: a Ugandan cohort study.

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