Early-Life exposure to environmental pollutants and endocrine disruptors: emerging risks and mechanistic insights in maternal, fetal, and child health.

Exposure to environmental pollutants and endocrine-disrupting chemicals (EDCs) in early life is a critical public health issue because it can alter developmental programming that impacts susceptibility to disease throughout life. The prenatal and early postnatal periods are times of vulnerability when exposure to environmental stressors may impact endocrine signalling, placental function, epigenetic regulation, and metabolic homeostasis. There is increasing evidence that exposure to bisphenols, phthalates, per- and polyfluoroalkyl substances (PFAS), pesticides, heavy metals, and air pollutants has been associated with pregnancy outcomes, neurodevelopmental disorders, metabolic dysfunction, endocrine abnormalities and reproductive impairments. Exposomics, high-resolution mass spectrometry, biomonitoring, and passive sampling technologies have made crucial advances in characterising complex environmental exposures. At the same time, novel methods such as multi-omics, single-cell sequencing, spatial biology and microbiome studies have yielded more detailed mechanistic understanding of how environmental factors can impact developmental processes via epigenetic, inflammatory, oxidative stress, and endocrine pathways. The placenta has emerged as a valuable biomarker matrix for assessing fetal exposure and developmental programming. Exposure routes, biomonitoring methods, placental processes, molecular and epigenetic modifications, and the impacts of early-life environmental exposures on neurodevelopment, metabolism, endocrine function, and reproduction are all summarised in this review. It also emphasises current advancements in exposure assessment, preventive measures, and policy frameworks, highlighting the importance of life-course perspectives and environmental justice. To identify important windows of susceptibility, improve risk assessment, and develop strategies to safeguard maternal and child health, exposomics in conjunction with systems biology and longitudinal epidemiological approaches will be essential.