From maternal microbial transmission to neonatal gut microbiota restoration: the potential and challenges of maternal fecal microbiota transplantation
Abstract
Early-life gut microbiota establishment is a critical developmental process shaped by maternal microbial transmission and ecological succession. Microorganisms from the maternal gut, vagina, breast milk, skin, and oral cavity contribute to neonatal microbial acquisition, while strain-resolved studies increasingly support the maternal gut as an important reservoir of strains capable of persistent colonization in the infant intestine. This transmission can be disrupted by cesarean delivery, prematurity, perinatal antibiotic exposure, and neonatal intensive care, resulting in delayed acquisition of maternal commensals, altered microbial succession, and increased colonization by opportunistic microorganisms. Current restoration strategies, including probiotics, synbiotics, and vaginal microbiota seeding, can modify early microbial communities but do not fully reproduce the diversity, maternal specificity, and persistence of naturally transmitted maternal gut strains. Maternal fecal microbiota transplantation (FMT) has therefore emerged as a potential strategy to restore disrupted maternal gut-to-infant microbial transmission. Initial proof-of-concept and strain-resolved studies suggest that carefully screened maternal FMT can increase mother-to-infant strain sharing, promote recovery from cesarean-associated microbiota perturbations, and reduce colonization by potential pathogens. However, evidence for durable engraftment, functional benefits, clinical efficacy, and long-term safety remains limited. Future studies should prioritize rigorous donor screening, standardized intervention protocols, appropriate recipient selection, and longitudinal integration of strain-resolved metagenomics, metabolomics, immune profiling, and clinical outcomes. Maternal FMT remains investigational but provides a promising framework for precision early-life microbiota restoration.
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BibTeX
@article{hu2026from,
title = {{From maternal microbial transmission to neonatal gut microbiota restoration: the potential and challenges of maternal fecal microbiota transplantation}},
author = {Xia Hu and Guangyu Ma and Jinbiao Han and Lijuan Zhu and Ying He and Dan Zhu},
journal = {Frontiers in Microbiology},
year = {2026},
month = oct,
doi = {10.3389/fmicb.2026.1972665},
url = {https://www.frontiersin.org/articles/10.3389/fmicb.2026.1972665},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - From maternal microbial transmission to neonatal gut microbiota restoration: the potential and challenges of maternal fecal microbiota transplantation
AU - Xia Hu
AU - Guangyu Ma
AU - Jinbiao Han
AU - Lijuan Zhu
AU - Ying He
AU - Dan Zhu
PY - 2026
DA - 2026/10/29
JO - Frontiers in Microbiology
DO - 10.3389/fmicb.2026.1972665
UR - https://www.frontiersin.org/articles/10.3389/fmicb.2026.1972665
AB - Early-life gut microbiota establishment is a critical developmental process shaped by maternal microbial transmission and ecological succession. Microorganisms from the maternal gut, vagina, breast milk, skin, and oral cavity contribute to neonatal microbial acquisition, while strain-resolved studies increasingly support the maternal gut as an important reservoir of strains capable of persistent colonization in the infant intestine. This transmission can be disrupted by cesarean delivery, prematurity, perinatal antibiotic exposure, and neonatal intensive care, resulting in delayed acquisition of maternal commensals, altered microbial succession, and increased colonization by opportunistic microorganisms. Current restoration strategies, including probiotics, synbiotics, and vaginal microbiota seeding, can modify early microbial communities but do not fully reproduce the diversity, maternal specificity, and persistence of naturally transmitted maternal gut strains. Maternal fecal microbiota transplantation (FMT) has therefore emerged as a potential strategy to restore disrupted maternal gut-to-infant microbial transmission. Initial proof-of-concept and strain-resolved studies suggest that carefully screened maternal FMT can increase mother-to-infant strain sharing, promote recovery from cesarean-associated microbiota perturbations, and reduce colonization by potential pathogens. However, evidence for durable engraftment, functional benefits, clinical efficacy, and long-term safety remains limited. Future studies should prioritize rigorous donor screening, standardized intervention protocols, appropriate recipient selection, and longitudinal integration of strain-resolved metagenomics, metabolomics, immune profiling, and clinical outcomes. Maternal FMT remains investigational but provides a promising framework for precision early-life microbiota restoration.
SN - 1664-302X
ER -