Ochratoxin A status at birth is associated with reduced birthweight 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 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 birthweight (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 height 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. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement The MISAME-III main trial work was supported by the Bill & Melinda Gates Foundation (OPP1175213). The mycotoxins sampling and analysis was supported by Fonds Wetenschappelijk Onderzoek (project No G085921N). MDB was supported by the European Research Council under the European Union Horizon 2020 research and innovation program (grant agreement No 946192, HUMYCO). The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: The study protocol was approved by the Ethical Committee of Ghent University Hospital in Belgium (B670201734334) and the Ethical Committee of Institut de Recherche en Sciences de la Santé in Burkina Faso (50-2020/CEIRES). Written informed consent was obtained from all subjects involved in the study. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes