Methanol poisoning in pregnancy: A hidden threat in obstetric care

Maternal methanol poisoning is rare but carries significant risks for both mother and fetus, including metabolic acidosis, visual and neurologic injury, and fetal compromise. Methanol freely crosses the placenta, and fetal metabolism of formate is limited, making the fetus particularly susceptible to hypoxic and metabolic injury. Clinical recognition is challenging due to nonspecific early symptoms, and prompt maternal stabilization with antidotal therapy, folate supplementation, and hemodialysis is critical to prevent irreversible fetal damage. Preventive strategies require a multidimensional approach, including public health education, regulatory oversight of methanol-containing products, and standardized clinical protocols for early recognition and treatment. Addressing social determinants of health and ensuring equitable access to maternal care are essential to mitigate risk among vulnerable populations. This review integrates biomedical, obstetric, and public health perspectives to provide a comprehensive overview of maternal-fetal toxicity, clinical presentation, diagnosis, management, and perinatal outcomes.