International Journal of Advance Nursing Practice

Introduction: Developmental malformations, also known as congenital anomalies, affect approximately 3-6% of live births globally and contribute significantly to neonatal and under-five mortality, particularly in low- and middle-income countries. Occupational exposures are increasingly recognized as important yet underappreciated determinants of adverse reproductive and fetal outcomes. Methods: A narrative review was conducted using PubMed, Scopus, Web of Science, and Google Scholar, including peer-reviewed studies from the past two decades focusing on maternal and paternal occupational exposures. Studies with rigorous exposure assessment methods, including Job-Exposure Matrices, were prioritized, and findings were synthesized thematically. Results: Strong associations were identified between occupational exposures particularly pesticides, organic solvents, heavy metals, and ionizing radiation and congenital anomalies such as neural tube defects, congenital heart diseases, and orofacial clefts. In adults, these exposures were also linked to chronic diseases and reproductive dysfunction. Both maternal and paternal exposures influenced fetal development through transplacental transfer and preconceptional genetic alterations. Conclusion: These findings highlight the intergenerational continuum linking adult occupational risks with pediatric outcomes, emphasizing a life-course, exposure-integrated approach that considers both direct and indirect pathways, including psychosocial and lifestyle factors.