Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2025 Jun 17;17(3):67.
doi: 10.3390/pediatric17030067.

Impact of Maternal Microbiota Composition on Neonatal Immunity and Early Childhood Allergies: A Systematic Review

Ayah Nabil Al Jehani  1 , Manal Shuaib  1 , Arwa Alsharif  1 , Khlood Abdulaziz Alsubaie  1 , Ayda Khraisat  1 , Abdulaziz Alsharif  2 , Manaf Altaf  2 , Ruba H Almasry  1 , Amal Mohamed Kayali  1 , Shouq Abdin Abdallah  3
Affiliations
Review

Impact of Maternal Microbiota Composition on Neonatal Immunity and Early Childhood Allergies: A Systematic Review

Ayah Nabil Al Jehani et al. Pediatr Rep. .

Abstract

Background: The maternal microbiota serve as a key regulator of neonatal immune development and early-life health outcomes. This systematic review aims to find out how the makeup of the maternal microbiota affects newborn immunity and the risk of allergies, identify which microbes are linked to a higher or lower chance of allergies, and assess treatments that could improve newborn immune health. Methods: We conducted a systematic search in PubMed, MEDLINE, and Web of Science, adhering to the PRISMA guidelines. We included randomized controlled trials (RCTs), cohort studies, and observational studies that looked at how the makeup of the maternal microbiota affects newborn immune responses or allergic outcomes in early life. We conducted a systematic search, and the quality of the studies was evaluated using the GRADE system and tools to check for bias (RoB 2, Newcastle-Ottawa Scale, MINORS). Results: We included a total of 74 studies. The main findings showed that having a cesarean delivery and using certain antibiotics during pregnancy increased the risk of allergies, while breastfeeding, taking probiotics, and changing the mother's diet helped to protect against allergies. Maternal stress had a negative association with the microbiota composition (OR = 1.9-2.4) and neonatal immune regulation. Moreover, the study noted significant geographic variation in the microbiota's influence, underscoring the importance of contextualized interventions. Conclusions: The composition of the maternal microbiota has a major impact on neonatal immunity and the risk of early-life allergy. Adverse factors include cesarean birth, antibiotic exposure, and maternal stress, all of which have been associated with alterations in neonatal immunity. More studies are required to validate promising microbiota-targeted strategies and develop evidence-based guidelines to improve maternal and neonatal immune health.

Keywords: allergy risk; breastfeeding; cesarean delivery; immune development; maternal microbiota; neonatal immunity; probiotics.

PubMed Disclaimer

Conflict of interest statement

The authors declare that there are no conflicts of interest.

Figures

Figure 1
Figure 1
Detailed PRISMA flowchart used for the systematic review, detailing the identification, screening, eligibility, and inclusion of studies evaluating the impact of the maternal microbiota composition on neonatal immunity and early-childhood allergies.
Figure 2
Figure 2
Microbiota interventions and allergy risk reduction.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Nyangahu D.D., Jaspan H.B. Influence of maternal microbiota during pregnancy on infant immunity. Clin. Exp. Immunol. 2019;198:47–56. doi: 10.1111/cei.13331. - DOI - PMC - PubMed
    1. Edwards S.M., Cunningham S.A., Dunlop A.L., Corwin E.J. The maternal gut microbiome during pregnancy. MCN Am. J. Matern. Child Nurs. 2017;42:310–317. doi: 10.1097/NMC.0000000000000372. - DOI - PMC - PubMed
    1. Jeong S. Factors influencing development of the infant microbiota: From prenatal period to early infancy. Clin. Exp. Pediatr. 2021;65:438–447. doi: 10.3345/cep.2021.00955. - DOI - PMC - PubMed
    1. Nunez N., Réot L., Menu E. Neonatal immune system ontogeny: The role of maternal microbiota and associated factors. How Might Non-Hum. Primate Model Enlighten Path? Vaccines. 2021;9:584. doi: 10.3390/vaccines9060584. - DOI - PMC - PubMed
    1. Dominguez-Bello M.G., Costello E.K., Contreras M., Magris M., Hidalgo G., Fierer N., Knight R. Delivery mode shapes the acquisition and structure of the initial microbiota across multiple body habitats in newborns. Proc. Natl. Acad. Sci. USA. 2010;107:11971–11975. doi: 10.1073/pnas.1002601107. - DOI - PMC - PubMed

LinkOut - more resources