Human teratogens and their impact on the developing brain: a scoping review

The impact of certain medication exposures in utero can be observed in the physical development of the fetus (e.g. patterns of congenital malformations or dysmorphic features) or in the form of growth disruption. Developmental trajectories within the fetal brain can also be susceptible to alteration and can manifest as lifelong neurodevelopmental impairments. Despite growing recognition of its importance as an outcome, a lack of coherence within the investigation of the neurodevelopmental outcomes remains. Important methodological clarity could be gained through reviewing published data regarding neurodevelopmental outcomes within the context of confirmed structural teratogens. This scoping review will use systematic searches to identify neurodevelopmental outcome data for medications demonstrated to alter the physical development of the fetus (i.e. structural malformations or growth disruption). Searches will be conducted in MEDLINE, EMBASE, and the specialized database Reprotox. Identified abstracts will be doubly reviewed against the eligibility criteria and data extracted. A narrative review will be undertaken, reporting on the key neurodevelopmental areas frequently altered, methodological features of completed studies (e.g. study designs, child characteristics, dose relationships, etc) and, importantly, the relationship between the structural alterations associated with the exposure and the observed neurodevelopmental outcomes.