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Optimizing Maternal Microbiome: Role in Improved Conception and Pregnancy Outcome.

Eytan R Barnea1,2, Amala Nazareth3, Chittaranjan N Purandare4

  • 1Society for the Investigation of Early Pregnancy (SIEP) New York New York USA.

Reproductive Medicine and Biology
|January 14, 2026
PubMed
Summary

Optimizing the maternal microbiome before and during early pregnancy improves fertility and reduces complications. Simple, cost-effective strategies are crucial for maternal and fetal health, especially in low- and middle-income countries.

Keywords:
conceptionmicrobiomepregnancypreventiontreatment

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Area of Science:

  • Reproductive Health
  • Microbiome Research
  • Maternal-Fetal Medicine

Background:

  • The maternal microbiome plays a critical role in fertility and pregnancy success.
  • Microbial dysbiosis is associated with adverse pregnancy outcomes and increased susceptibility to infections.

Purpose of the Study:

  • To assess the impact of optimizing the maternal microbiome on pregnancy outcomes.
  • To propose diagnostic and preventive strategies for preconception and early gestation, with a focus on low- and middle-income countries (LMICs).

Main Methods:

  • A comprehensive literature review analyzed the influence of various body site microbiomes (vaginal, endometrial, gastrointestinal, urinary, oral) on fertility and pregnancy.
  • Evaluated diagnostic methods (cultures, gene sequencing) and preventive interventions (nutrition, probiotics, vaccinations).

Main Results:

  • An optimized microbiome, characterized by *Lactobacillus crispatus* dominance, enhances fertility and lowers risks of miscarriage, preterm birth, and congenital infections.
  • Microbial dysbiosis, linked to lifestyle factors, increases risks. Preconception screening and targeted treatments improve outcomes.
  • Nutritional interventions and supplements support microbial health. LMICs face significant challenges in accessing care and nutrition.

Conclusions:

  • Preconception microbiome optimization via diagnostics, lifestyle modifications, and targeted therapies significantly enhances pregnancy outcomes.
  • Implementing simple, cost-effective measures is vital for reducing maternal and fetal morbidity and mortality, particularly in LMICs.