Integrating environmental exposure assessment into maternal and neonatal care: a practical mini-review

Environmental exposure assessment remains under-integrated in maternal and neonatal care despite growing evidence that pregnancy, fetal development, and early neonatal life are highly sensitive periods during which environmental exposures may influence immediate and longer-term health. This narrative mini-review highlights the clinical relevance of environmental exposures in maternal and neonatal practice, outlines why exposure assessment remains underused in routine care, and proposes a pragmatic framework for integration. Key barriers include limited clinician training, unclear referral pathways, and the perception that environmental risks are difficult to assess and interpret in clinical settings. A targeted approach may be most appropriate in high-risk pregnancies, unexplained adverse outcomes, fetal growth restriction, preterm birth, and medically vulnerable neonates. A practical framework based on recognizing higher-risk situations, obtaining a focused exposure history, and acting through counseling, referral, or selective testing is proposed to help bring environmental health closer to routine maternal and neonatal care. What is Known? • Pregnancy, fetal development, and early neonatal life are highly sensitive periods during which environmental exposures may influence health and development. • Environmental exposure assessment remains underused in routine maternal and neonatal care because of limited clinician training, unclear referral pathways, and uncertainty about how to act on exposure concerns. What is New? • This narrative mini-review proposes a practical framework for integrating environmental exposure assessment intomaternal and neonatal care through focused history taking, counseling, referral, and selective testing when appropriate. • A practical screening table is provided with example exposure questions, red flags, and suggested clinical actions to support real-world clinical decision-making.