Probiotics in pregnancy: Potential impact on fetal epigenetic programming and neurodevelopmental trajectories in offspring

The maternal gut microbiome plays a pivotal role in shaping pregnancy outcomes. Probiotics are known to support maternal immune function, reduce infection risk, modulate inflammation, and contribute to the prevention of gestational complications such as preeclampsia and diabetes. These effects are largely mediated through alteration in the maternal gut microbiota and the production of microbial metabolites, particularly short-chain fatty acids, which exert direct regulatory effects on the host epigenome. In recent years, increasing attention has focused on the use of probiotics during pregnancy, not only for their benefits on maternal immunity and metabolism but also for their potential to influence the fetal epigenome and, specifically, brain development. Fetal brain epigenetic programming is characterized by a remarkable degree of plasticity and is highly responsive to environmental factors, such as maternal diet, lifestyle, stress, gut microbic status and nutritional supplementation. Understanding the complex relationship between probiotic-induced changes in maternal microbiota and fetal epigenetic modifications, such as DNA methylation, histone modifications, and non-coding RNA regulation, is essential for clarifying how gestational supplementation may shape neurodevelopmental patterns in offspring. This review examines the targeting of pregnancy-associated dysbiosis with probiotics supplementation as a potential and hypothesis-generating strategy that may contribute to favourable epigenetic programming and is associated with neurodevelopmental trajectories relevant to later-life mental health.