The impact of prenatal organophosphate exposure on children’s neurodevelopment: a quantitative analysis with regional comparison

Organophosphate (OP) exposure leads to global concern on its human neurotoxic effects although the conclusions are controversial. This study aimed to assess the relationship between prenatal OP exposure and neurodevelopment in children using a meta-analysis. Published articles before or on 10 April 2025 were retrieved from four databases, Web of Science, PubMed, EBSCOhost, and Cochrane Library. Finally, 46 articles with 25,975 participants were included. Four group and regional subgroup analyses were conducted using either random or common effect models. The pooled estimates indicated that prenatal OP exposure was significantly associated with a decrease in children's cognition. In subgroup analysis, prenatal OP exposure was significantly associated with a decrease in Asian and North American children's cognition, and Asian children's motor activity. Furthermore, OP exposure was significantly associated with an increased risk of adverse neurodevelopmental outcomes in both Asian and North American children. However, a significantly positive association between prenatal OP exposure and children behavior group and North America subgroup was detected. In conclusion, prenatal OP exposure significantly impairs children's neurodevelopment, with stronger effects in Asian populations, underscoring the need for region-specific interventions and policies.