How maternal diet, probiotics, prebiotics, and postbiotics during pregnancy influence neurodevelopment in newborns

• Perinatal microbiota shapes fetal brain and microglial maturation. • Dysbiosis in pregnancy disrupts microglia, raising neurodevelopmental risks. • Mediterranean Diet-microbiota and probiotics, prebiotics, and postbiotics promote eubiotic microbiota and neuroprotection. • Maternal microbial interventions may guide optimal child brain development. The maternal microbiota plays a pivotal role in shaping fetal and neonatal neurodevelopment through the gut–brain axis. Modern lifestyles, cesarean delivery, formula feeding, and Westernized diets contribute to maternal and neonatal dysbiosis, increasing the risk of neurodevelopmental, metabolic, and immune disorders in offspring. This review explores how maternal diet, microbiota composition, probiotics, prebiotics, and postbiotics during pregnancy and lactation influence the microbial and neurodevelopmental trajectory of newborns. Evidence suggests that prenatal microbial transfer begins in utero, while birth mode and breastfeeding strongly shape early microbial colonization. Dysbiosis, maternal immune activation, and pro-inflammatory conditions such as obesity or gestational diabetes disrupt microglial maturation and increase the risk of neurodevelopmental disorders, including autism spectrum disorder, ADHD, and mood disorders. Conversely, maternal adherence to a Mediterranean diet, combined with selected probiotic, prebiotic, and postbiotic supplementation, supports microbial diversity, enhances barrier function, and promotes neuroprotective metabolite production. In conclusion, early maternal interventions targeting microbiota composition—through diet and microbial therapies—represent a promising strategy to optimize neonatal neurodevelopment and long-term health. Future personalized approaches, guided by maternal microbiota profiling, could strengthen preventive pediatric care.