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May 1, 2026Trends in Immunology2 citationsOpen Access

Microbes, molecules, and the maternal–fetal interface: rethinking the gut–placenta axis

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GBGabriela BarrientosFFFabian B. FahlbuschMCMelanie L. Conrad

Key Points

  • This review aims to explore how maternal microbiome-derived signals influence placental function and fetal outcomes.
  • Synthesized evidence from gnotobiotic and supplementation models
  • Investigated circulating microbial signals and their association with placental functions
  • Analyzed limitations in existing human studies
  • Circulating signals such as short-chain fatty acids and indoles impact placental vascular development, immune regulation, and nutrient transport.
  • Key gaps in translating findings from animal models to human pregnancy outcomes were identified.
  • Microbial ecology in mothers shapes a network of mediators affecting crucial placental processes.

Abstract

Placental biology is increasingly framed through a signaling paradigm in which maternal microbiome-derived mediators-rather than microbial colonization-affect the function of the interface. This review synthesizes evidence that circulating microbial signals, including short-chain fatty acids, tryptophan-derived indoles, bile-acid-linked ligands, microbe-associated molecular patterns, and bacterial extracellular vesicles, are associated with placental vascular development, immune regulation, nutrient transport, and endocrine programs-processes central to pregnancy outcomes. We integrate mechanistic insights from gnotobiotic and supplementation models with limitations of human evidence and identify key translational gaps. The current evidence supports a model in which maternal microbial ecology shapes a network of circulating mediators that converge on interlinked placental pathways essential for placental function and fetal development.

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Cite This Study

Barrientos et al. (2026) studied this question.

synapsesocial.com/papers/69f44223967e944ac5565e27https://doi.org/10.1016/j.it.2026.03.010
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