Research Progress on the Impact of Organophosphate Pesticide Exposure on Pregnancy Complications and Adverse Birth Outcomes
Organophosphate pesticides (OPs), the most extensively used insecticides globally, are ubiquitous in environmental matrices and agricultural products, leading to widespread human exposure. This systematic review evaluates the impact of OP exposure on pregnancy complications and adverse birth outcomes, synthesizing evidence from 58 epidemiological studies published between January 2001 and July 2024. Exposure assessment methods, including biomarkers such as urinary dialkyl phosphates, are critically examined. The review finds significant associations between OP exposure and increased risks of spontaneous abortion, gestational diabetes mellitus, gestational hypertension, preeclampsia, preterm birth, and adverse birth outcomes such as low birth weight and reduced head circumference. Potential mechanisms include paraoxonase 1 (PON1) genotype polymorphisms affecting detoxification capacity, oxidative stress, inflammation, metabolic disruption, and altered placental gene networks. The review highlights inconsistencies across studies due to variability in exposure assessment, timing, and population susceptibility. Future research should prioritize longitudinal designs, repeated biomarker measurements, and consideration of PON1 genetic variants to clarify causal relationships and susceptible windows. This comprehensive synthesis provides critical insights for regulatory policies and clinical interventions aimed at mitigating maternal and child health risks from OP exposure.