Abstract:

Prenatal exposure to heavy metals constitutes an important but often under-recognized environmental risk factor influencing pregnancy outcomes and perinatal health. This article reviews recent evidence (2020–2025) addressing how exposure to metals such as cadmium (Cd), lead (Pb), mercury (Hg), arsenic (As), chromium (Cr), nickel (Ni), and mixtures thereof impact maternal health, fetal growth, birth outcomes, and longer-term neonatal consequences. We discuss mechanisms of toxicity, critical windows of vulnerability, and the role of mixed exposures and environmental context. The review summarises observational and cohort studies showing associations with outcomes including preterm birth, small for gestational age (SGA), low birth weight (LBW), stillbirth, and neurodevelopmental sequelae. Findings emphasize that even relatively low exposures may exert measurable effects, and that environmental regulation, biomonitoring, and clinical awareness are required to mitigate these risks. The article concludes with recommendations for research, policy, and practice.