Organophosphate flame retardants (OPFRs) are found in
various environmental
matrixes and human samples. Exposure to OPFRs during gestation may
interfere with pregnancy, for example, inducing maternal oxidative
stress and maternal hypertension during pregnancy, interfering maternal
and fetal thyroid hormone secretion and fetal neurodevelopment, and
causing fetal metabolic abnormalities. However, the consequences of
OPFR exposure on pregnant women, impact on mother-to-child transmission
of OPFRs, and harmful effects on fetal and pregnancy outcomes have
not been evaluated. This review describes the exposure to OPFRs in
pregnant women worldwide, based on metabolites of OPFRs (mOPs) in
urine for prenatal exposure and OPFRs in breast milk for postnatal
exposure. Predictors of maternal exposure to OPFRs and variability
of mOPs in urine have been discussed. Mother-to-child transmission
pathways of OPFRs have been scrutinized, considering the levels of
OPFRs and their metabolites in amniotic fluid, placenta, deciduae,
chorionic villi, and cord blood. The results showed that bis(1,3-dichloro-2-propyl)
phosphate (BDCIPP) and diphenyl phosphate (DPHP) were the two predominant
mOPs in urine, with detection frequencies of >90%. The estimated
daily
intake (EDIM) indicates low risk when infants are exposed
to OPFRs from breast milk. Furthermore, higher exposure levels of
OPFRs in pregnant women may increase the risk of adverse pregnancy
outcomes and influence the developmental behavior of infants. This
review summarizes the knowledge gaps of OPFRs in pregnant women and
highlights the crucial steps for assessing health risks in susceptible
populations, such as pregnant women and fetuses.