Pesticide Exposures during Pregnancy and Health Outcomes in Latin America and the Caribbean: A Scoping Review of Human Observational Studies.

Background: Latin America and the Caribbean (LAC) are regions with intense pesticide use. Numerous studies have demonstrated the adverse health effects associated with pesticide exposure. The embryonic and fetal periods are particularly susceptible to xenobiotics, with pesticides exhibiting potentially teratogenic effects.

Objectives: The objective was to review the scientific literature on outcomes associated with prenatal pesticide exposure, identifying challenges and gaps in this field.

Methods: We conducted a scoping review using terms related to pesticides, LAC, and pregnancy across six databases. The final search was conducted on 5 March 2024. The inclusion criteria for the studies were as follows: a) being human observational studies involving pregnant women of any age or gestational age duration, newborns from these pregnancies, or both; b) reporting any exposure to pesticide and any adverse outcome; c) having been conducted in any country of LAC; d) having been published between 1 January 2000 and 5 March 2024; e) having the full text available in English, Spanish, or Portuguese; and f) presenting original results. Nonoriginal research papers, such as qualitative studies, reviews, critical analyses, and opinion papers, were excluded. The included studies were categorized and presented based on the outcomes they evaluated.

Results: We included 80 studies conducted in 13 countries; the included studies encompassed obstetric outcomes, anthropometric parameters, congenital anomalies, neurodevelopment, respiratory infections, and childhood leukemia, as well as molecular effects. Organochlorines were the primary type of exposure investigated among the included studies. Many studies relied on indirect measures of pesticide exposure.

Discussion: Adverse outcomes associated with prenatal pesticide exposure have been observed in Latin American and Caribbean populations, consistent with the global literature. Significant knowledge gaps remain, especially regarding groups of pesticides other than organochlorines. Less than half of the countries in LAC have conducted any study on the potential effects of prenatal exposure. Ongoing research into the risks of prenatal exposure is imperative. It is essential to consider the region's unique characteristics, particularly when investigating the risks associated with pesticides authorized exclusively in this region. https://doi.org/10.1289/JHP1043.