母体脱氧雪腐镰刀菌烯醇暴露与出生结局的不良关联：中国一项前瞻性队列研究。
Adverse associations between maternal deoxynivalenol exposure and birth outcomes: a prospective cohort study in China.
机构信息
Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, 13 Hangkong Road, Wuhan, 430030, Hubei, China.
Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, 430030, Hubei, China.
出版信息
BMC Med. 2023 Aug 28;21(1):328. doi: 10.1186/s12916-023-03011-5.
BACKGROUND
Deoxynivalenol (DON), one of the most prevalent mycotoxins, has been found to cause fetal growth retardation in animals. However, limited evidence exists regarding its effects on pregnant women.
METHODS
Maternal urinary concentration of total DON (tDON) and free DON (fDON) in the second trimester was measured using liquid chromatography with tandem mass spectrometry. Provisional daily intake (PDI) of DON was calculated based on tDON concentration. Linear and logistic regression models were used to evaluate the association between DON exposure levels and birth weight, birth length, and the risk of small for gestational age (SGA).
RESULTS
Among 1538 subjects, the median concentrations of tDON and fDON were 12.1 ng/mL and 5.1 ng/mL, respectively. The PDI values revealed that the median DON intake was 0.7 µg/kg bw, and 35.9% of the total population exceeded the provisional maximum tolerable daily intake (PMTDI) of 1 µg/kg bw. Compared with the lowest tertile, birth weight decreased by 81.11 g (95% CI: -127.00, -35.23) for tDON (P-trend < 0.001) and 63.02 g (95% CI: -108.72, -17.32) for fDON (P-trend = 0.004) in the highest tertile. Each unit increase in Ln-tDON and Ln-fDON was also inversely associated with birth weight. Furthermore, compared to those who did not exceed PMTDI, pregnant women whose PDI exceeded PMTDI had lower birth weight (β = -79.79 g; 95% CI: -119.09, -40.49) and birth length (β = -0.21 cm; 95% CI: -0.34, -0.07), and a higher risk of SGA (OR = 1.48; 95% CI: 1.02, 2.15) in their offspring. Similar associations with birth weight, birth length, and SGA were found when comparing the highest tertile of PDI to the lowest tertile (all P-trend < 0.05).
CONCLUSIONS
Maternal DON exposure is related to decreased birth weight. Our findings implicate that DON exposure during pregnancy may cause fetal growth faltering, and measures should be taken to reduce DON exposure in pregnant women.
背景
脱氧雪腐镰刀菌烯醇（DON）是最常见的霉菌毒素之一，已被发现可导致动物胎儿生长迟缓。然而，关于其对孕妇的影响，证据有限。
方法
采用液相色谱-串联质谱法测定 1538 例孕妇妊娠中期尿中总 DON（tDON）和游离 DON（fDON）的浓度。根据 tDON 浓度计算 DON 的暂定日摄入量（PDI）。采用线性和逻辑回归模型评估 DON 暴露水平与出生体重、出生长度和小于胎龄儿（SGA）风险之间的关系。
结果
在 1538 名受试者中，tDON 和 fDON 的中位数浓度分别为 12.1ng/mL 和 5.1ng/mL。PDI 值显示，DON 的中位摄入量为 0.7µg/kg bw，总人群中有 35.9%超过了暂定最大耐受日摄入量（PMTDI）1µg/kg bw。与最低三分位相比，tDON 最高三分位的出生体重下降 81.11g（95%CI：-127.00，-35.23）（P 趋势<0.001），fDON 最高三分位的出生体重下降 63.02g（95%CI：-108.72，-17.32）（P 趋势=0.004）。tDON 和 fDON 的 Ln 值每增加一个单位，与出生体重也呈负相关。此外，与未超过 PMTDI 的孕妇相比，PDI 超过 PMTDI 的孕妇其子女的出生体重（β=-79.79g；95%CI：-119.09，-40.49）和出生长度（β=-0.21cm；95%CI：-0.34，-0.07）较低，SGA 的风险增加（OR=1.48；95%CI：1.02，2.15）。将 PDI 的最高三分位与最低三分位进行比较时，也发现了与出生体重、出生长度和 SGA 相似的关联（均 P 趋势<0.05）。
结论
母体 DON 暴露与出生体重下降有关。我们的研究结果表明，孕妇 DON 暴露可能导致胎儿生长迟缓，应采取措施减少孕妇 DON 暴露。
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