Maternal microbiome impacts neonatal immune and brain development.

Vaginal birth, breastfeeding, and SSC influence neonatal gut microbiome.

Cesarean section reduces infant microbial diversity and immune development.

Vaginal seeding and breastfeeding help restore infant gut microbiota.

Maternal microbial diversity influences long-term neonatal health risks.

Historically, multigenerational health and disease transmission have primarily focused on genetic inheritance. However, the discovery that beneficial microorganisms known as commensal microbiota outnumber human genes tenfold has reshaped this perspective, highlighting their critical role in maintaining homeostasis and protecting against pathogens. Unlike the human genome, commensal microbiota is not genetically inherited but is acquired anew with each generation. with initial gut colonization playing a pivotal role in shaping an infant's immune system, neurodevelopment, and long-term health, all heavily influenced by maternal factors. In this review, we examine emerging research on maternal microbial influences on the fetus beginning in utero. We provide an updated overview of the current insights into the impact of the vaginal microbiome during parturition on offspring immunity and discuss the potential long-term health implications for infants born via cesarean section. We explore the advantages and limitations of techniques designed to mitigate these effects, such as vaginal seeding and emphasize that the development of the neonatal immune system is a dynamic process influenced by maternal factors beyond birth, including the transfer of microbiota through breast milk and skin contact. Finally, we present gaps in current research and propose future research directions to deepen our understanding of the impacts of the maternal microbiome on her child. Together, these insights demonstrate how maternal influence on offspring health and immunity extends beyond genetic factors, encompassing the transmission of microbiota, which, in turn, has profound long-term implications for health and disease resilience, offering a novel perspective on intergenerational health dynamics.

Fecal microbiota transplantation

Human milk oligosaccharides

Gut-brain-axis

Vaginal birth

Vaginal seeding

Cesarian section

Breast milk

Skin-to-skin contact

Microbiota

© 2025 The Authors. Published by Elsevier B.V.