Neurodevelopmental Outcomes Associated with Early-Life Exposure to Heavy Metals: A Systematic Review

André Soares da Silva, Renata Maria Silva Santos (), Patricia Gazire De Marco, Victhor Hugo Martins Rezende, Tamires Coelho Martins, Joyce Romano Silva, Marco Aurélio Romano-Silva and Débora Marques de Miranda
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André Soares da Silva: Graduate Program in Molecular Medicine, Faculty of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte 30130-100, Brazil
Renata Maria Silva Santos: Graduate Program in Molecular Medicine, Faculty of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte 30130-100, Brazil
Patricia Gazire De Marco: Graduate Program in Molecular Medicine, Faculty of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte 30130-100, Brazil
Victhor Hugo Martins Rezende: Graduate Program in Molecular Medicine, Faculty of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte 30130-100, Brazil
Tamires Coelho Martins: Graduate Program in Molecular Medicine, Faculty of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte 30130-100, Brazil
Joyce Romano Silva: Graduate Program in Molecular Medicine, Faculty of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte 30130-100, Brazil
Marco Aurélio Romano-Silva: Department of Psychiatry, Faculty of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte 30130-100, Brazil
Débora Marques de Miranda: Department of Pediatrics, Faculty of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte 30130-100, Brazil

IJERPH, 2025, vol. 22, issue 8, 1-27

Abstract: Introduction: Globally, approximately 53 million children under the age of five live with some form of developmental disability. Exposure to heavy metals has been identified in the literature as a contributing factor in the etiology of neurodevelopmental disorders, however it usually is understudied. Even at low concentrations, these toxicants pose a risk to neurodevelopment, when affecting children early as in the prenatal period. This study aims to systematically review the literature on the associations between exposure to toxic heavy metals and neurodevelopmental outcomes in children. Method: The review was registered at the International Prospective Register of Systematic Review-PROSPERO, under number CRD420250653229 and searches were conducted in the PubMed, Scopus, Web of Science, EMBASE, Lilacs and PsycInfo databases. Results: A total of 68 articles were included, comprising 48 longitudinal studies and 20 cross-sectional studies, published between 2006 and 2025, with a combined sample of 215,195 individuals from 23 countries. Lead was the most consistently investigated metal, appearing in 75% of the studies, followed by mercury, cadmium, and arsenic. Most findings referred to prenatal exposure. Cognitive and motor outcomes were predominantly affected by exposure to Pb and Hg, while behavioral outcomes showed negative associations mainly with Pb and As. Conclusions: The majority of the studies analyzed indicated adverse effects resulting from exposure to heavy metals during pregnancy, especially in the early months, highlighting the vulnerability of the developing brain.

Keywords: heavy metals; neurodevelopmental; children; lead; mercury; cadmium; arsenic (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2025
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