Mycotoxin exposure from food occurs globally but is more common in hot humid environments, especially in low-income settings, and might affect pregnancy outcomes. This study aimed to synthesize the evidence from epidemiological studies on the relationship between maternal or fetal exposure to different mycotoxins and the occurrence of adverse pregnancy outcomes. Multiple databases were systematically searched up to December 2018 to identify studies that assessed the association between mycotoxin exposure in pregnant women or fetuses and at least one pregnancy outcome. Studies were appraised and results were synthesized using standard methods for conducting systematic reviews. This review identified and included 17 relevant studies. There is some evidence to suggest that exposure to various Aspergillus mycotoxins (e.g., aflatoxin) during pregnancy may impair intrauterine fetal growth and promote neonatal jaundice. Findings were inconclusive concerning the influence of aflatoxin exposure on perinatal death and preterm birth. Only two studies assessed effects of maternal exposure to Fusarium mycotoxins (e.g., fumonisin) on adverse pregnancy outcomes. These studies found that maternal fumonisin exposure may be associated with hypertensive emergencies in pregnancy and with neural tube defects. Studies using grain farming and weather conditions as a proxy measure for mycotoxin exposure found that such exposure was associated with an increased risk of preterm birth and late-term miscarriage. In conclusion, there is already some evidence to suggest that exposure to mycotoxins during pregnancy may have detrimental effects on pregnancy outcomes. However, given the limited number of studies, especially on effects of Fusarium mycotoxins, more studies are needed for a more comprehensive understanding of the effects of different mycotoxins on maternal and fetal health and to guide public health policies and interventions.

中文翻译：

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孕妇霉菌毒素暴露和不良妊娠结局：系统评价。

食物中的霉菌毒素暴露发生在全球各地，但在湿热的环境中（尤其是在低收入环境中）更为常见，并可能影响妊娠结局。这项研究旨在从流行病学研究中综合证据，以了解母体或胎儿暴露于不同真菌毒素与不良妊娠结局的发生之间的关系。截至2018年12月，系统地搜索了多个数据库，以鉴定评估孕妇或胎儿中霉菌毒素暴露与至少一项妊娠结局之间关系的研究。使用标准方法进行研究评估并合成结果，以进行系统的评价。该评价确定并包括17项相关研究。有证据表明暴露于各种曲霉怀孕期间的霉菌毒素（例如，黄曲霉毒素）可能会损害子宫内胎儿的生长并促进新生儿黄疸。关于黄曲霉毒素暴露对围产期死亡和早产的影响尚无定论。只有两项研究评估了孕妇暴露于镰刀菌的影响霉菌毒素（例如伏马毒素）对不良妊娠结局的影响。这些研究发现，孕产妇伏马毒素的暴露可能与妊娠高血压急症和神经管缺陷有关。使用谷物种植和天气条件作为霉菌毒素暴露替代指标的研究发现，此类暴露与早产和后期流产的风险增加有关。总之，已经有一些证据表明，怀孕期间暴露于霉菌毒素可能对怀孕结局有不利影响。但是，由于研究数量有限，尤其是关于镰刀菌的研究 霉菌毒素，需要更多的研究以更全面地了解不同霉菌毒素对孕产妇和胎儿健康的影响，并指导公共卫生政策和干预措施。