Ochratoxin A status at birth is associated with reduced birth weight and ponderal index in rural Burkina Faso

Background: Mycotoxin exposure during pregnancy has been associated with adverse birth outcomes and poor infant growth. We assessed multiple biomarkers and metabolites of exposure to mycotoxins at birth and their associations with birth outcomes and infant growth in 274 newborns in rural Burkina Faso.

Methods and findings: Whole blood microsamples were analyzed for mycotoxin concentrations in newborns in the Biospecimen sub-study nested in the MISAME-III trial using ultra performance liquid chromatography coupled to tandem mass spectrometry. Unadjusted and adjusted associations between mycotoxin exposure, and birth outcomes and infant growth at 6 months were estimated using linear regression models for continuous outcomes and linear probability models with robust variance estimation for binary outcomes. Infant growth trajectories from birth to 6 months were compared by exposure status using mixed-effects models with random intercept for the individual infant and random slope for the infant's age. Ochratoxin A (OTA) exposure was detected in 38.3% of newborns, with other mycotoxins being detected in the range of 0.36% and 4.01%. OTA exposure was significantly associated with adverse birth outcomes, such as lower birth weight (β (95% CI): -0.11 kg (-0.21, 0.00); p = 0.042) and ponderal index (β (95% CI): -0.62 gm/cm³ (-1.19, -0.05); p = 0.034), and a marginally significant lower length growth trajectories during the first 6 months (β (95% CI): -0.08 cm/mo (-0.15, 0.0); p = 0.057).

Conclusions: OTA exposure was prevalent among newborns and also associated with lower growth at birth and during the first 6 months. The results emphasize the importance of nutrition-sensitive strategies to mitigate dietary OTA, as well as adopting food safety measures in Burkina Faso during the fetal period of development.