Inflammatory Response Clinical Trial
Official title:
Association Among Maternal Environmental Enteric Dysfunction, Aflatoxin Exposure, and Birth Outcomes: A Prospective Cohort Study in Mukono, Uganda
This prospective cohort study focuses on the relationship between maternal environmental enteric dysfunction (EED) and maternal aflatoxin B1 exposure and birth outcomes, particularly infant anthropometry and gestational age, in Mukono, Uganda.
The problem of stunting, which has long-term health and economic consequences both at the
individual and population level, persists in low and middle income countries (LMICs). It has
been recognized that an estimated 20% of stunting begins in-utero. Although poor maternal
nutrition during pregnancy is often blamed, it has been hypothesized that maternal EED status
and maternal aflatoxin exposure during pregnancy may also play a role. However, to date,
there have been no studies which have attempted to show the association between EED in
pregnant women and negative birth outcomes. Furthermore, few studies have examined the
association between maternal aflatoxin exposure during pregnancy and negative birth outcomes.
In this prospective cohort study, pregnant women were enrolled at their first prenatal visit
and birth outcome data was assessed within 48 hours of delivery. EED was measured via
lactulose: mannitol (L:M) ratios and serum concentrations of antibodies to the bacterial
components flagellin and lipopolysaccharide (LPS). Aflatoxin exposure was assessed by
measuring the serum concentration of AFB1-lysine adduct from a blood sample taken at
enrollment. Data on covariates were obtained from two surveys, one at enrollment and one
three weeks prior to participant's estimated date of delivery.
The specific aims of this study were as follows:
1. To evaluate the relationship between markers of EED in pregnancy and negative birth
outcomes, including low birth weight, stunting at birth, small head circumference, and
premature delivery.
2. To evaluate the relationship aflatoxin B1 exposure in pregnancy and negative birth
outcomes, including low birth weight, stunting at birth, small head circumference, and
premature delivery.
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