Microbiome Signatures as Predictive Biomarkers in Maternal and Neonatal Health: A Path Toward Precision Medicine

The complications that arise from pregnancy such as preterm birth (PTB), preeclampsia, and neonatal sepsis continue to pose significant threats to maternal and neonatal health worldwide. Early detection and treatment are crucial in reducing the morbidity and mortality of these complications. The human microbiome, particularly during the perinatal period, has also been seen as a critical regulator of immune and metabolic health, influencing both maternal and infant outcomes. This narrative review responds to the application of microbiome signatures as predictors for maternal and neonatal health biomarkers. We summarize new evidence linking dysbiosis of both maternal gut and vaginal microbiomes with PTB, preeclampsia, and gestational diabetes mellitus (GDM). We further discussed how the neonatal microbiome affects immune development and is association to sepsis risk. This review also briefly addresses the crossroads of multiomics data to enhance precision medicine, the shortcomings in designing adequately powered clinical trials, and the standardization and regulatory hurdles confronting the microbiome field. As much as the potential of microbiome signatures for predictive diagnostics in maternal and neonatal health is high, there are daunting challenges to overcome. They include the dynamic nature of the neonatal microbiome, the nature of multiomics data complexity, and invoking standardized methodologies and robust clinical trials. Nevertheless, the incorporation of microbiome‐based biomarkers into medicine has the potential to move toward more personalized, noninvasive, and effective management of maternal and neonatal health.