Prenatal exposure to endocrine disruptors and its effects on maternal–fetal health

Endocrine-disrupting chemicals (EDCs) are pervasive environmental contaminants that interfere with hormonal regulation and pose risks during pregnancy, a developmental period of heightened endocrine sensitivity. Prenatal exposure to major EDC classes, including bisphenols, phthalates, pesticides, and persistent organic pollutants, is associated with adverse maternal outcomes and long-term metabolic, neurodevelopmental, and reproductive effects in offspring. This review integrates the current evidence on the principal sources and pathways of prenatal EDC exposure and examines the mechanistic foundations of developmental toxicity, focusing on nuclear receptor perturbation, epigenetic reprogramming, and oxidative stress. Epidemiological and clinical findings linking EDCs to gestational diabetes, hypertensive disorders, preterm birth, and developmental origins of health and disease are summarized, with attention to sex-specific susceptibilities and emerging transgenerational effects of EDC exposure. Finally, we translate these insights into practical recommendations for prenatal care and discuss regulatory considerations that incorporate mixture toxicity, non-monotonic dose-response, and early life vulnerability. Collectively, these findings underscore the need for precautionary, evidence-based strategies to safeguard maternal and child health against widespread chemical exposure. • Prenatal exposure to endocrine-disrupting chemicals (EDCs) poses significant risks to maternal and fetal health during pregnancy. • Key EDCs, including bisphenols, phthalates, pesticides, and persistent organic pollutants, are linked to adverse maternal outcomes and long-term effects on offspring. • Mechanisms of developmental toxicity include nuclear receptor disruption, epigenetic reprogramming, and oxidative stress, affecting critical hormonal pathways. • EDCs are associated with increased risks of gestational diabetes, hypertensive disorders, preterm birth, and developmental health outcomes. • Sex-specific susceptibilities and transgenerational effects underscore the long-lasting consequences of prenatal EDC exposure. • Practical recommendations for minimizing prenatal EDC exposure are provided, emphasizing behavioral modifications in prenatal care. • Regulatory frameworks must address mixture toxicity, non-monotonic dose-response, and fetal susceptibility to protect maternal and child health.