{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T16:54:21Z","timestamp":1782924861422,"version":"3.54.5"},"reference-count":116,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"1","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,1]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n                  <jats:p>\n                    The association between maternal aflatoxin exposure and infant anthropometric birth and growth outcomes was investigated in the present study, controlling for possible confounders\n                    <jats:italic>.<\/jats:italic>\n                    Pregnant women (\n                    <jats:italic>N<\/jats:italic>\n                    = 1,210) from 16 Ugandan subcounties were enrolled in a birth cohort study to track birth outcomes and subsequent growth of infants. Serum concentrations of aflatoxin B\n                    <jats:sub>1<\/jats:sub>\n                    (AFB\n                    <jats:sub>1<\/jats:sub>\n                    )-lysine adduct, environmental enteric dysfunction markers of anti-lipopolysaccharide and anti-flagellin IgG and IgA, and markers of systemic inflammation, alpha-1 acid glycoprotein, and C-reactive protein were measured in mothers at birth and infants at 6 months of age. A generalized estimating equations model with an exchangeable correlation matrix was used to assess associations between maternal AFB\n                    <jats:sub>1<\/jats:sub>\n                    blood concentration and weight, length, weight-for-age (WAZ), length-for-age (LAZ), and weight-for-length (WLZ) Z scores. Multivariable linear and logistic regressions were used to assess the association between infant aflatoxin concentrations and growth outcomes at 3 to 6 months of age. Serum aflatoxin concentrations in women at parturition were associated with reduced birth weight (\n                    <jats:italic>P<\/jats:italic>\n                    = 0.037) and WAZ (\n                    <jats:italic>P<\/jats:italic>\n                    = 0.034), but not with other birth outcomes. Aflatoxin concentrations in infants 6 months of age were not associated with changes in weight, height, WAZ, LAZ, or WLZ between 3 and 6 months of age. The present study confirmed an association between maternal aflatoxin and specific birth outcomes, but not between infant serum aflatoxin and infant early growth, which may be due to low exposure to aflatoxin-contaminated foods in early life. This finding highlights the importance of promoting national policy actions that minimize aflatoxin contamination of local food supplies, both on farms and in markets.\n                  <\/jats:p>","DOI":"10.4269\/ajtmh.25-0426","type":"journal-article","created":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T13:21:24Z","timestamp":1778160084000},"page":"167-175","source":"Crossref","is-referenced-by-count":0,"title":["Maternal Aflatoxin Exposure, Birth Outcomes, and Infant Growth in Uganda"],"prefix":"10.4269","volume":"115","author":[{"given":"Lynne M.","family":"Ausman","sequence":"first","affiliation":[{"name":"Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts, USA;"},{"name":"Department of Public Health and Community Medicine, Tufts University, School of Medicine, Boston, Massachusetts, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grace","family":"Namirembe","sequence":"additional","affiliation":[{"name":"Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julieta","family":"Mezzano","sequence":"additional","affiliation":[{"name":"Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacqueline M.","family":"Lauer","sequence":"additional","affiliation":[{"name":"Sargent College of Health & Rehabilitation Sciences, Boston University, Boston, Massachusetts, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robin","family":"Shrestha","sequence":"additional","affiliation":[{"name":"Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edgar","family":"Agaba","sequence":"additional","affiliation":[{"name":"Stellenbosch University, South Africa;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernard","family":"Bashaasha","sequence":"additional","affiliation":[{"name":"Department of Agribusiness and Natural Resource Economics, Makerere University, Kampala, Uganda;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey K.","family":"Griffiths","sequence":"additional","affiliation":[{"name":"Department of Public Health and Community Medicine, Tufts University, School of Medicine, Boston, Massachusetts, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Marino-Costello","sequence":"additional","affiliation":[{"name":"Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jia-Sheng","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Environmental Health Science, University of Georgia, Athens, Georgia, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juergen G.","family":"Erhardt","sequence":"additional","affiliation":[{"name":"University of Hohenheim, Institute of Biological Chemistry and Nutrition, Stuttgart, Germany;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew T.","family":"Gewirtz","sequence":"additional","affiliation":[{"name":"Institute for Biomedical Sciences, Georgia State University, Atlanta, Georgia, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher P.","family":"Duggan","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology and Nutrition, Boston Children\u2019s Hospital, Boston, Massachusetts, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Webb","sequence":"additional","affiliation":[{"name":"Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shibani","family":"Ghosh","sequence":"additional","affiliation":[{"name":"Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts, USA;"},{"name":"Division of Nutritional Sciences, College of Human Ecology, Cornell University, Ithaca, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"b1","article-title":"The State of Food Security and Nutrition in the World 2024.","year":"2024"},{"issue":"3\u20134","key":"b2","series-title":"Toxin Rev","first-page":"171","article-title":"Discovery of aflatoxins and significant historical 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strategies","volume":"97","author":"Umesha","year":"2017"},{"issue":"3","key":"b7","series-title":"Toxins (Basel)","first-page":"204","article-title":"Physical and chemical methods for reduction in aflatoxin content of feed and food","volume":"13","author":"Sipos","year":"2021"},{"key":"b8","series-title":"Trends Food Sci Technol","first-page":"73","article-title":"A review of novel physical and chemical decontamination technologies for aflatoxin in food","volume":"71","author":"Pankaj","year":"2018"},{"issue":"21","key":"b9","series-title":"Int J Mol Sci","first-page":"8187","article-title":"Molecular aspects of mycotoxins\u2014A serious problem for human health","volume":"21","author":"Janik","year":"2020"},{"issue":"3","key":"b10","series-title":"Compr Rev Food Sci Food Saf","first-page":"2286","article-title":"The aflatoxin situation in Africa: Systematic literature review","volume":"20","author":"Meijer","year":"2021"},{"key":"b11","series-title":"Environ 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infants","volume":"149","author":"Andrews-Trevino","year":"2019"},{"issue":"2","key":"b15","series-title":"Matern Child Nutr","first-page":"e12701","article-title":"Maternal aflatoxin exposure during pregnancy and adverse birth outcomes in Uganda","volume":"15","author":"Lauer","year":"2019"},{"issue":"9","key":"b16","series-title":"Br J Nutr","first-page":"781","article-title":"Aflatoxin exposure during pregnancy or infancy and its effect on infant health: A narrative review","volume":"134","author":"Gorain","year":"2025"},{"issue":"10","key":"b17","series-title":"Toxins (Basel)","first-page":"619","article-title":"The compromised intestinal barrier induced by mycotoxins","volume":"12","author":"Gao","year":"2020"},{"issue":"3","key":"b18","series-title":"Int J Food Sci Nutr","first-page":"241","article-title":"Dietary aflatoxins exposure, environmental enteropathy, and their relation with childhood 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Malaysia","volume":"215","author":"Leong","year":"2012"},{"issue":"2","key":"b44","series-title":"Trop Med Int Health","first-page":"160","article-title":"Association between birth outcomes and aflatoxin B 1 biomarker blood levels in pregnant women in Kumasi, Ghana","volume":"15","author":"Shuaib","year":"2010"},{"issue":"5","key":"b45","series-title":"Int J Epidemiol","first-page":"1119","article-title":"Aflatoxin exposure in utero causes growth faltering in Gambian infants","volume":"36","author":"Turner","year":"2007"},{"issue":"1","key":"b46","series-title":"Ann Trop Paediatr","first-page":"3","article-title":"Fetal exposure to aflatoxins in the United Arab Emirates","volume":"22","author":"Abdulrazzaq","year":"2002"},{"issue":"4","key":"b47","series-title":"Risk Anal","first-page":"860","article-title":"Mycotoxins were not associated with environmental enteropathy in a cohort of Tanzanian children","volume":"43","author":"Chen","year":"2023"},{"key":"b48","series-title":"J 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Nutr","first-page":"e13359","article-title":"Child stunting starts in utero: Growth trajectories and determinants in Ugandan infants","volume":"18","author":"Namirembe","year":"2022"},{"issue":"7","key":"b25","series-title":"Matern Child Health J","first-page":"1516","article-title":"Effects of iron and vitamin A levels on pregnant women and birth outcomes: Complex relationships untangled using a birth cohort study in Uganda","volume":"26","author":"Mezzano","year":"2022"},{"key":"b26","article-title":"Guideline on Haemoglobin Cutoffs to Define Anaemia in Individuals and Populations.","year":"2024"},{"key":"b27","article-title":"Household Food Insecurity Access Scale (HFIAS) for Measurement of Food Access: Indicator Guide: Version 3: (576842013-001).","author":"Coates","year":"2007"},{"issue":"2","key":"b28","series-title":"Am J Physiol Regul Integr Comp Physiol","first-page":"R402","article-title":"Detectable serum flagellin and lipopolysaccharide and upregulated anti-flagellin and 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