Murashiki Tatenda Clive, Munjoma Privilege Tendai, Zinyama-Gutsire Rutendo B L, Mutingwende Isaac, Mazengera Lovemore Ronald, Duri Kerina
Immunology Unit, Department of Laboratory, Diagnostic and Investigative Sciences, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe.
Department of Pharmacy and Pharmaceutical Sciences, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe.
Drug Chem Toxicol. 2025 Jul;48(4):842-855. doi: 10.1080/01480545.2024.2448675. Epub 2025 Jan 4.
Aflatoxin B (AFB1) and fumonisin B (FB1) are toxic secondary products of fungi that frequently contaminate staple crops in resource-limited settings. Antenatal AFB1 and FB1 exposure may cause adverse birth outcomes. We conducted a retrospective substudy nested in a case-control cohort of HIV-infected and HIV-uninfected women ≥20 weeks gestation from Harare, Zimbabwe. Urinary aflatoxin M (AFM1) and FB1, biomarkers of AFB1 and FB1 exposure, respectively, were quantified in random antenatal urine via ELISA and grouped into tertiles. The adverse birth outcomes considered were low birth weight, preterm birth (PTB), small for gestational age, stillbirth, birth defects, neonatal death, neonatal jaundice and perinatal death (PD). We evaluated any associations between adverse birth outcomes and exposure to AFB1, FB1, or the AFB1-FB1 combination via a multivariable logistic regression controlled for potential confounders. We enrolled 94 HIV-infected and 81 HIV-uninfected women. In HIV-infected, AFM1 was detected in 46/94 (49%), and FB1 was detected in 86/94 (91%). In HIV-uninfected, AFM1 was detected in 48/81 (59%), and FB1 was detected in 74/81 (91%). Among all women, AFM1 tertile 3 was associated with PD (OR: 6.95; 95% CI: 1.21-39.78). In the same population, AFM1 tertiles 2 (OR: 13.46; 95% CI: 1.20-150.11) and 3 (OR: 7.92; 95% CI: 1.08-58.19) were associated with PTB. In HIV-infected, AFM1 tertile 2 was associated with PTB (OR: 64.73; 95% CI: 2.37-177.93). Our results revealed an association between AFB1 exposure and PD and PTB in women, including those infected with HIV. Public health and nutrition measures are necessary to mitigate mycotoxins.
黄曲霉毒素B（AFB1）和伏马毒素B（FB1）是真菌产生的有毒次生代谢产物，在资源有限地区常污染主要农作物。产前暴露于AFB1和FB1可能导致不良出生结局。我们在一个病例对照队列中进行了一项回顾性子研究，该队列纳入了来自津巴布韦哈拉雷的妊娠≥20周的感染HIV和未感染HIV的女性。分别通过酶联免疫吸附测定法（ELISA）对随机采集的产前尿液中的黄曲霉毒素M（AFM1）和FB1（分别为AFB1和FB1暴露的生物标志物）进行定量，并分为三分位数。所考虑的不良出生结局包括低出生体重、早产（PTB）、小于胎龄儿、死产、出生缺陷、新生儿死亡、新生儿黄疸和围产期死亡（PD）。我们通过多变量逻辑回归评估了不良出生结局与AFB1、FB1或AFB1 - FB1组合暴露之间的任何关联，并对潜在混杂因素进行了控制。我们纳入了94名感染HIV的女性和81名未感染HIV的女性。在感染HIV的女性中，46/94（49%）检测到AFM1，86/94（91%）检测到FB1。在未感染HIV的女性中，48/81（59%）检测到AFM1，74/81（91%）检测到FB1。在所有女性中，AFM1三分位数3与PD相关（比值比：6.95；95%置信区间：1.21 - 39.78）。在同一人群中，AFM1三分位数2（比值比：13.46；95%置信区间：1.20 - 150.11）和3（比值比：7.92；95%置信区间：1.08 - 58.19）与PTB相关。在感染HIV的女性中，AFM1三分位数2与PTB相关（比值比：64.73；95%置信区间：2.37 - 177.93）。我们的结果揭示了AFB1暴露与女性（包括感染HIV的女性）的PD和PTB之间的关联。采取公共卫生和营养措施来减轻霉菌毒素污染是必要的。
