Determinants of anemia among pregnant women in Mali

BACKGROUND: Anemia in pregnancy remains a major problem in nearly all developing and many industrialized countries. In Mali, the subpopulation prevalence and etiology of anemia during pregnancy are largely unknown. OBJECTIVE: To examine the prevalence and likely etiologies of anemia in pregnancy in a poor urban population in Bamako, Mali. METHODS: Pregnant women (n = 190) were selected randomly. Hemoglobin, serum iron, and total iron-binding capacity were measured; blood smears were examined for Plasmodium falciparum malaria; and single stool and urine samples were examined for Schistosoma haematobium and hookworm. Gynecologic examinations were performed and interviews conducted to qualitatively assess food consumption and other socioeconomic characteristics. Associations among mild, moderate, and severe anemia; iron and parasite status; erythrocyte sedimentation rates; and the presence of abnormal vaginal discharge were evaluated. Differences in hemoglobin and serum iron concentrations, total iron-binding capacity, and anemia were compared according to trimester of pregnancy and between infected and noninfected women. The relative and attributable risks of anemia were calculated, and adjusted odds ratios for anemia and low serum iron were estimated by multivariate logistic regression. RESULTS: Of the 131 women for whom complete data were available, 47% had hemoglobin concentrations below 110 g/L; 13% had serum iron concentrations below 12 micromol/L; none had transferrin saturation values below 16%; 11%, 23%, and 8% harbored P. falciparum, S. haematobium, and hookworm, respectively; and 82% had an abnormal vaginal discharge. Food restrictions were reported by 45% of the women. Abnormal vaginal discharge correlated significantly with anemia (Pearson chi2 = 62.4; p < .01). Univariate and multivariate analyses found that infections were strongly associated with and predictive of anemia. CONCLUSIONS: Our data suggest that infections and food accessibility contribute to the high rates of anemia during pregnancy in Mali.     

The search for microorganisms sensitive to deoxynivalenol, zearalenone and aflatoxin B1

Sensitivity to T-2 toxin, deoxynivalenol (DOV), zearalenon (ZL) and aflatoxin (AT) B1 was comparatively studied in yeast strains Saccharomyces fragilis 25 D, Candida pseudotropicalis 44 nk and Saccharomyces lactis BKMY-459, sensitive to T-2 toxin, and strain Bacillus megaterium BKMB-44, sensitive to toxic metabolites of Aspergillus species of fungi. Minimum amounts of T-2 toxin inducing on Silufol plates sites of the yeast strain growth suppression, comprised 20-50 ng, maximum sensitivity was recorded in Saccharomyces lactis BKMY-459. Minimum content of DOV suppressing the yeast growth comprised 10-50 micrograms, and that of ZL 10-25 micrograms. Bacillus megaterium BKMB-44 culture proved to be highly sensitive to AT B1, 1 microgram of which suppressed the strain growth. This culture was resistant to T-2 toxin and DOV in doses of 1 microgram and 200 micrograms, respectively. ZL suppressed Bacillus megaterium growth when its minimum content in the plaque was 0.5 = 1 microgram. The authors have considered the possibility of using the microorganism strains studied for screening toxic grain lots and toxigenic fungus strains.     

Deoxynivalenol exposure assessment in a cohort of pregnant women from Bradford,UK

Deoxynivalenol (DON) is a ubiquitous contaminant of cereal crops in temperate regions of the world. It causes growth faltering and immune suppression in animals. Limited information is available on DON exposure in UK subpopulations. The objective of this study was to provide DON exposure assessment in a subset of pregnant women scheduled for an elective caesarean in a large multi-ethnic mother/infant birth cohort from Bradford, UK. Women aged 16–44 years (n?=?85) provided a urine sample for DON analysis in the last trimester of pregnancy, and concurrently completed a food-frequency questionnaire (FFQ). The urinary DON biomarker was detected in all measured samples (geometric mean (GM)?=?10.3?ng?DON?mg^?1 creatinine, range?=?0.5?116.7?ng?mg^?1). Levels were higher in women classified as South Asian in origin (GM: 15.2?ng?mg^?1; 95% CI?=?10.7?21.5?ng?mg^?1) compared with non-South Asians (GM?=?8.6?ng?mg^?1; 95% CI?=?6.6?11.8?ng?mg^?1), p?=?0.02). Estimated DON intake from FFQ data and typical levels of DON contamination of food suggest that this was mainly due to higher levels of exposure from bread, particularly daily intake of DON from chapattis in South Asians (estimated mean?=?2.4?µg?day^?1; 95% CI?=?1.2, 3.7?µg?day^?1) compared with non-South Asians (estimated mean?=?0.2?µg?day^?1; 95% CI?=?0?0.4?µg?day^?1), p?<?0.001. This is the first biomarker demonstration of DON exposure in pregnant women, and several urinary DON levels were the highest ever recorded in any study. A larger survey within this birth cohort is warranted to investigate any potential risk to mothers and their babies, from DON exposure during pregnancy.     

Deoxynivalenol exposure assessment in a cohort of pregnant women from Bradford, UK

Deoxynivalenol (DON) is a ubiquitous contaminant of cereal crops in temperate regions of the world. It causes growth faltering and immune suppression in animals. Limited information is available on DON exposure in UK subpopulations. The objective of this study was to provide DON exposure assessment in a subset of pregnant women scheduled for an elective caesarean in a large multi-ethnic mother/infant birth cohort from Bradford, UK. Women aged 16-44 years (n = 85) provided a urine sample for DON analysis in the last trimester of pregnancy, and concurrently completed a food-frequency questionnaire (FFQ). The urinary DON biomarker was detected in all measured samples (geometric mean (GM)?= 10.3 ng DON mg(-1) creatinine, range = 0.5-116.7 ng mg(-1)). Levels were higher in women classified as South Asian in origin (GM: 15.2 ng mg(-1); 95% CI = 10.7-21.5 ng mg(-1)) compared with non-South Asians (GM = 8.6 ng mg(-1); 95% CI = 6.6-11.8 ng mg(-1)), p = 0.02). Estimated DON intake from FFQ data and typical levels of DON contamination of food suggest that this was mainly due to higher levels of exposure from bread, particularly daily intake of DON from chapattis in South Asians (estimated mean = 2.4 μg day(-1); 95% CI = 1.2, 3.7 μg day(-1)) compared with non-South Asians (estimated mean = 0.2 μg day(-1); 95% CI = 0-0.4 μg day(-1)), p < 0.001. This is the first biomarker demonstration of DON exposure in pregnant women, and several urinary DON levels were the highest ever recorded in any study. A larger survey within this birth cohort is warranted to investigate any potential risk to mothers and their babies, from DON exposure during pregnancy.     

Concentrations and exposure estimates of deoxynivalenol in wheat products from Argentina

The aim of this work was to determine deoxynivalenol (DON) contamination in wheat-based food products in Argentina and to estimate DON exposure. The numbers of samples were determined according to a developed sampling plan. A total of 156 samples of different wheat products were randomly collected from food markets in Luján, Argentina, and analyzed for DON by gas chromatography. DON contamination ranged 7–271?ng?g^?1 for French bread, 5–149?ng?g^?1 for Vienna bread, 11–85?ng?g^?1 for crackers, 8–85?ng?g^?1 for pizza, and was 79?ng?g^?1 for noodles. The maximum contribution to DON intake was 7% of the PMTDI for French bread; the minimum was less than 1% for noodles. Assuming all groups had eaten all sampled foods and summing all groups’ intake contribution, the highest estimate DON exposure would only be <14% (for the 18–24-year old men group) of the DON daily dietary intake.     

Prevalence of anemia among pregnant women and adolescent girls in 16 districts of India

BACKGROUND: Nutritional anemia is one of India's major public health problems. The prevalence of anemia ranges from 33% to 89% among pregnant women and is more than 60% among adolescent girls. Under the anemia prevention and control program of the Government of India, iron and folic acid tablets are distributed to pregnant women, but no such program exists for adolescent girls. OBJECTIVE: To assess the status of anemia among pregnant women and adolescent girls from 16 districts of 11 states of India. METHODS: A two-stage random sampling method was used to select 30 clusters on the basis of probability proportional to size. Anemia was diagnosed by estimating the hemoglobin concentration in the blood with the use of the indirect cyanmethemoglobin method. RESULTS: The survey data showed that 84.9% of pregnant women (n = 6,923) were anemic (hemoglobin < 110 g/L); 13.1% had severe anemia (hemoglobin < 70 g/L), and 60.1% had moderate anemia (hemoglobin > or = 70 to 100 g/L). Among adolescent girls (n = 4,337)from 16 districts, the overall prevalence of anemia (defined as hemoglobin < 120 g/L) was 90.1%, with 7.1% having severe anemia (hemoglobin < 70 g/L). CONCLUSIONS: Any intervention strategy for this population must address not only the problem of iron deficiency, but also deficiencies of other micronutrients, such as B12 and folic acid and other possible causal factors.     

Incidence of aflatoxin B1 in the Egyptian cured meat basterma and control by gamma-irradiation

In the present studies trials have been carried out to investigate the occurrence of aflatoxin B1 in the Egyptian cured meat basterma and to control such contamination by gamma-rays. Basterma was prepared from fresh salted meat coated with spice paste and stored at room temperature. The total mould counts of basterma samples varied from 10(3) to 10(6) cfu/g in summer months and from 10(2) to 10(5) cfu/g in winter months. Aspergillus, Penicillium, Mucor, Rhizopus, Fusarium and Cladosporium were the most common fungal genera isolated from basterma samples and its components. Basterma samples contained total aflatoxins at levels from 2.8 to 47 microg x kg(-1). Aflatoxins were determined in the spice paste at levels from 9.6 to 120 microg x kg(-1) and in pepper (285.6 microg x kg(-1)), garlic (224.4 microg x kg(-1)), fenugreek (194.2 microg x kg(-1)), coriander (16 and capsicum (42.4 microg x kg(-1)). At an irradiation dose level of 3 kGy, only one sample each of pepper, fenugreek, and spice paste were contaminated with aflatoxins and all basterma samples and its components were free from aflatoxins at an irradiation dose level of 5 kGy.     

Food safety practices among pregnant women and mothers in the women, infants, and children program, Miami, Florida

Pregnant women and infants are two groups at the highest risk of severe outcomes from foodborne illnesses. We surveyed adult clients of a Women, Infants, and Children (WIC) clinic serving predominately African Americans in inner-city Miami, Florida, to assess food safety practices. Eligible and consenting women completed a 23-item self-administered survey with questions concerning food handling practices around the Partnership for Food Safety Education's Fight BAC! campaign constructs of "clean", "separate" (not cross-contaminated), "cook", and "chill". Of 342 eligible clients, 299 (87.4%) consented to participate. In general, the clients' food safety practices were most problematic in the cook and chill constructs. Using a cooking thermometer, refrigerating foods within 2 h, and thawing them safely were the least commonly reported safe practices. Women who were pregnant with their first child had the lowest food safety practice scores. Of the 62 pregnant participants, 32 (51.6%) reported eating hot dogs or deli meats without first reheating them some of the time or more often, and 22 (35.5%) reported eating soft cheeses and blue-veined cheeses some of the time or more often, putting the women at risk of listeriosis. Although all women in the WIC program could benefit from food safety education, these findings indicate that women during their first pregnancy should especially be targeted for food safety education.     

Determinants of aflatoxin M1 in breast milk in a selected group of Egyptian mothers.

In Egypt, there is a paucity of biomarker data on aflatoxin (AF) exposure. The study assessed the level and frequency of breast milk AFM1 as a biomarker of maternal exposure. Breast milk samples were collected from a selected group of 388 Egyptian lactating mothers of children attending the New El-Qalyub Hospital, Qalyubiyah governorate, Egypt, during May-September 2003. Following aflatoxin extraction, AFM1 levels were assessed by high-performance liquid chromatography (HPLC) with fluorescence detection. Approximately 36% of mothers tested positive for AFM1 (median 13.5 pg ml-1, interquartile range (IQR) 10.27-21.43). Non-working status (p = 0.018, odds ratio (OR) = 2.87), obesity (p = 0.004, OR = 3.01), high corn oil consumption (p = 0.002, OR = 2.21), number of children (>1) (p = 0.025, OR = 1.99), and early lactation stage (<1 month) (p = 0.028 OR = 3.57), contributed to the occurrence of AF in breast milk. AFM1 contamination of breast milk was frequent, albeit at moderate levels. Growth and development of the infant is rapid and thus it is possible that AF exposure through breast milk has a significant health effect.     

Urine metabolite analysis as a function of deoxynivalenol exposure: an NMR-based metabolomics investigation

Deoxynivalenol (DON) is a toxic fungal metabolite that frequently contaminates cereal crops including wheat, maize and barley. Despite knowledge of frequent exposure through diet, our understanding of the potential consequences of human exposure remains limited, in part due to the lack of validated exposure biomarkers. In this study, we interrogated the urinary metabolome using nuclear magnetic resonance (NMR) spectroscopy to compare individuals with known low and high DON exposure through consumption of their normal diet. Urine samples from 22 adults from the UK (seven males, 15 females; age range = 21–59 years) had previously determined urinary DON levels using an established liquid chromatography-mass spectrometry (LC-MS) assay. Urine samples were subsequently analysed using an NMR-based metabolomics approach coupled with multivariate statistical analysis. Metabolic profiling suggested that hippurate levels could be used to distinguish between groups with low (3.6 ng DON mg^?1 creatinine: 95% CI = 2.6, 5.0 ng mg^?1) and high (11.1 ng mg^?1: 95% CI = 8.1, 15.5 ng mg^?1) DON exposure, with the concentration of hippurate being significantly (1.5 times) higher for people with high DON exposure than for those with low DON exposure (p = 0.047). This, to our knowledge, is the first report of a metabolomics-derived biomarker of DON exposure in humans.     

Determinants of serum polybrominated diphenyl ether (PBDE) levels among pregnant women in the CHAMACOS cohort

We measured levels of 10 polybrominated diphenyl ether (PBDE) congeners in serum collected during pregnancy and at delivery from 416 pregnant, predominantly immigrant, women living in Monterey County, CA. The most frequently detected congeners were BDE-47, -99, -100, and -153, all components of the penta mixture, detected in >97% of samples. We used multivariable regression models to examine factors associated with exposure to individual PBDE congeners as well as their total summed concentration (ng/g lipid). Prenatal and delivery total PBDE levels were correlated between sampling times (n = 21; Pearson r = 0.99, p < 0.001). In multivariable models, total PBDE levels increased significantly with time residing in the U.S. (p < 0.001) and among women with ≥3 pieces of stuffed furniture in their homes (p < 0.05). Women's total PBDE levels increased 4.0% (95% CI = 2.8, 5.3) for each additional year residing in the U.S., after adjustment for prepregnancy BMI, weight gain during pregnancy, and SES. Having ≥3 pieces of stuffed furniture in the home was associated with a 26.8% (95% CI = 2.0, 57.5) increase in women's serum PBDE levels. Findings suggest PBDE indoor contamination in California homes is contributing to human exposures in a population of recent immigrants.     

Food patterns during an economic crisis among pregnant women in Purworejo District, Central Java, Indonesia

A cross-sectional study was conducted between 1996 and 1998. Six 24-hour recalls were performed during the second trimester of pregnancy among 450 women in Purworejo District, Central Java, Indonesia. The objectives of the study were to assess the food intake and food pattern among pregnant women before and during the economic crisis. Before the crisis, rich women had the highest intakes of animal foods, fats and oils, and sugar. Food intake among the urban poor and the rural landless poor subgroups was influenced by the emerging economic crisis. Although the price of rice increased, the intake of rice also increased among all subgroups. Rural poor women with access to rice fields increased their intake of rice and decreased their intake of nonrice staple foods (p < .05). There were significant decreases in the consumption of chicken by rich women and rural poor women with access to rice fields (p < .05). Rice was a strongly inferior good and remained an important supplier of energy, protein, and carbohydrate. Nuts and pulses were important suppliers of calcium and iron, and vegetables were an important supplier of vitamin A. Rich women increased their intake of nuts and pulses, vegetables, fats and oils, and sugar when their intake of rice increased (p < .05). The food patterns were based on rice, nuts and pulses, and vegetables, i.e., plant food. All but the rich women decreased their intake of nutritious foods such as meat, chicken, and fruits. The intake of nuts and pulses and of vegetables increased, whereas the intake of cooking oil and sugar remained constant.     

孕妇电磁防护织物的设计方法

介绍了电磁辐射防护织物的电磁防护作用机理及织物的设计方法,阐述了孕妇电磁防护织物设计的注意要点。研究为开发具有较好的稳定性、舒适性、防护性及可洗性的孕妇电磁防护织物提供一定的参考依据。     

Multistate outbreak of Listeria monocytogenes associated with Mexican-style cheese made from pasteurized milk among pregnant, Hispanic women

Listeriosis is a severe infection caused by Listeria monocytogenes. Since 2004, the Centers for Disease Control and Prevention has requested that listeriosis patients be interviewed using a standardized Listeria Initiative (LI) questionnaire. In January 2009, states and the Centers for Disease Control and Prevention began investigating a multistate outbreak of listeriosis among pregnant, Hispanic women. We defined a case as an illness occurring between October 2008 and March 2009 with an L. monocytogenes isolate indistinguishable from the outbreak strain by pulsed-field gel electrophoresis. We conducted a multistate case-control study using controls that were selected from L. monocytogenes illnesses in non-outbreak-related pregnant, Hispanic women that were reported to the LI during 2004 to 2008. Eight cases in five states were identified. Seven of these were pregnant, Hispanic females aged 21 to 43 years, and one was a 3-year-old Hispanic girl, who was excluded from the study. Seven (100%) cases but only 26 (60%) of 43 controls had consumed Mexican-style cheese in the month before illness (odds ratio, 5.89; 95% confidence interval, 1.07 to ∞; P = 0.04). Cultures of asadero cheese made from pasteurized milk collected at a manufacturing facility during routine sampling by the Michigan Department of Agriculture on 23 February 2009 yielded the outbreak strain, leading to a recall of cheeses produced in the plant. Recalled product was traced to stores where at least three of the women had purchased cheese. This investigation highlights the usefulness of routine product sampling for identifying contaminated foods, of pulsed-field gel electrophoresis analysis to detect multistate outbreaks, and of the LI for providing timely exposure information for case-control analyses. Recalls of contaminated cheeses likely prevented additional illnesses.     

Quantitative dietary exposure assessment of the Catalonian population (Spain) to the mycotoxin deoxynivalenol

The mycotoxin deoxynivalenol (DON) is one of the most common contaminants of cereals worldwide, and its occurrence has been widely reported in raw foods and foodstuffs, around the European region, including Catalonia. In the present work, a stochastic methodology has been applied to accurately assess the exposure of the Catalonian population (Spain) to DON through food consumption. Raw contamination data was provided by a large survey conducted in this region, in addition to the raw consumption data from a nutritional study specifically designed to assess the dietary intake of the main foodstuffs related to DON contamination for all population age groups. Contamination and consumption data were combined by simulation using an essentially parametric (P-P) method. The P-P method draws sampling values from distribution functions fitted to consumption and contamination data sets. Moreover, to quantify the accuracy and reliability of the statistics estimates, we built the related confidence intervals using a pseudo-parametric bootstrap method. Considering the results drawn from the P-P simulation method, the Catalonian population should be expected to be exposed at moderated levels of deoxynivalenol, the infants and individuals with ethnic dietary patterns being the most exposed population groups     

Quantitative dietary exposure assessment of the Catalonian population (Spain) to the mycotoxin deoxynivalenol

The mycotoxin deoxynivalenol (DON) is one of the most common contaminants of cereals worldwide, and its occurrence has been widely reported in raw foods and foodstuffs, around the European region, including Catalonia. In the present work, a stochastic methodology has been applied to accurately assess the exposure of the Catalonian population (Spain) to DON through food consumption. Raw contamination data was provided by a large survey conducted in this region, in addition to the raw consumption data from a nutritional study specifically designed to assess the dietary intake of the main foodstuffs related to DON contamination for all population age groups. Contamination and consumption data were combined by simulation using an essentially parametric (P-P) method. The P-P method draws sampling values from distribution functions fitted to consumption and contamination data sets. Moreover, to quantify the accuracy and reliability of the statistics estimates, we built the related confidence intervals using a pseudo-parametric bootstrap method. Considering the results drawn from the P-P simulation method, the Catalonian population should be expected to be exposed at moderated levels of deoxynivalenol, the infants and individuals with ethnic dietary patterns being the most exposed population groups.