da Silva André Soares, Santos Renata Maria Silva, De Marco Patricia Gazire, Rezende Victhor Hugo Martins, Martins Tamires Coelho, Silva Joyce Romano, Romano-Silva Marco Aurélio, Miranda Débora Marques de
Graduate Program in Molecular Medicine, Faculty of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte 30130-100, Brazil.
Department of Psychiatry, Faculty of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte 30130-100, Brazil.
Int J Environ Res Public Health. 2025 Aug 21;22(8):1308. doi: 10.3390/ijerph22081308.
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.
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.
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.
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.
在全球范围内，约有5300万五岁以下儿童患有某种形式的发育障碍。文献已证实接触重金属是神经发育障碍病因中的一个促成因素，然而这一因素通常未得到充分研究。即使在低浓度下，这些有毒物质在影响儿童早期（如在孕期）时也会对神经发育构成风险。本研究旨在系统回顾有关儿童接触有毒重金属与神经发育结果之间关联的文献。
该综述已在国际系统评价前瞻性注册库（PROSPERO）注册，注册号为CRD420250653229，并在PubMed、Scopus、科学网、EMBASE、Lilacs和PsycInfo数据库中进行了检索。
共纳入68篇文章，包括48项纵向研究和20项横断面研究，发表于2006年至2025年之间，样本来自23个国家，共计215195人。铅是研究最一致的金属，出现在75%的研究中，其次是汞、镉和砷。大多数研究结果涉及产前接触。认知和运动结果主要受铅和汞接触的影响，而行为结果主要与铅和砷呈负相关。
大多数分析研究表明孕期接触重金属会产生不良影响，尤其是在怀孕早期，这突出了发育中大脑的脆弱性。
