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.