Prenatal Exposure to Organochlorine Compounds and Other Pesticides: A Systematic Review of Neonatal Health Outcomes

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Abstract Objective: To identify, evaluate, and summarize evidence on the effects of prenatal exposure to organochlorine compounds (OCCs) and other pesticides on neonatal growth parameters. Methods: Keywords were identified through systematic reviews and expert consultation, then finalized with an academic librarian. A comprehensive search was conducted in PubMed, Cochrane Library, MEDLINE (OVID), Scopus, Web of Science, and CINAHL from inception to February 26, 2024. Retrieved records were managed using EndNote 20. Two independent reviewers screened titles and abstracts based on predefined eligibility criteria. Full-text articles were further assessed for inclusion, with disagreements resolved by a third reviewer. A standardized process was followed during the full-text review. Studies were included if they involved pregnant women and their neonates, assessed prenatal exposure to OCCs, and reported at least one neonatal growth parameter. Data were extracted using Microsoft Excel ® and included study design, sample characteristics, exposure details (timing, route, and measurement), and neonatal growth outcomes. Methodological quality was assessed using the National Institutes of Health Quality Assessment Tool. Results: This systematic review included 16 studies conducted between 1997 and 2023 across various countries, with the majority from the United States ( n = 6). The studies employed diverse designs, including cohort, case-control, longitudinal cohort, and cross-sectional studies, to investigate the impact of prenatal pesticide exposure on neonatal health outcomes. Key neonatal growth parameters assessed were birth weight, length, head circumference, and gestational age. The quality of the included studies varied, with overall scores ranging between 64.28%-91.66%. Conclusion: The findings demonstrate significant associations between prenatal exposure to OCCs and adverse neonatal growth outcomes. Frequently reported effects included reduced birth weight, smaller head circumference, shorter gestational age, and increased risk of growth restriction. These results underscore the importance of minimizing maternal exposure to persistent organic pollutants during pregnancy and highlight the need for targeted public health policies and preventive strategies. Registration No.: CRD42024621439.