Maternal deoxynivalenol exposure associated with adverse birth outcomes observed in China

1. Compared to those consuming below the maximum tolerable daily intake of the mycotoxin deoxynivalenol, those consuming above this threshold were at a greater risk of giving birth to small-for gestational age infants. 

Evidence rating level: 1 (Excellent)

Deoxynivalenol (DON) is a mycotoxin found in certain agricultural products, such as wheat and corn. It has been found to cause fetal growth retardation in animals, but its effects have not previously been studied in humans. Researchers aimed to assess the effect of DON consumption on fetal growth. 1538 participants were included in this prospective study via the Tongji Maternal and Child Health Cohort (TMCHC) in Wuhan, China. Liquid chromatography with tandem mass spectrometry were used to measure both total (tDON) and free (fDON) DON in urine during the second trimester, which was then used to infer the daily intake of DON. 35.9% of subjects were found to exceed the provisional maximum daily intake of DON, which is 1 µg/kg bw. After adjusting for confounding variables, greater urinary tDON was inversely associated with birth weight (adjusted β = -22.00 g, 95% CI: -37.11, -6.89). Compared to the lowest third of tDON concentrations, birth weight was decreased by 81.11 g (95% CI: -127.00, -35.23) for the highest third (p <0.001). Compared to those below the maximum tolerable daily intake, those above this threshold had offspring with lower birth weight (β = -79.79 g; 95% CI: -119.09, -40.49) and greater risk of small-for gestational age (SGA) (OR = 1.48; 95% CI: 1.02, 2.15). A limitation of this study is that there may be additional confounding variables that were not adjusted for, such as the consumption of toxins other than DON. Overall, this study suggests that stricter regulations on the levels of DON in food products should be enforced for the protection of fetal health. 

Click to read the study in BMC Medicine

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