Maternal and child nutrition insecurity, microbiome and early neurodevelopment: a complex interplay

Abstract Background Nutrition insecurity (NI) is a significant public health issue of special interest to mothers and children due to its impact on several aspects of health and development. This study investigated the relationships between maternal and child NI, microbiome alterations and neurodevelopment. Methods A systematic scientific literature review was conducted through PubMed, Scopus and Web of Science according to PRISMA guidelines. For each eligible study data on maternal characteristics, nutritional status, microbiota composition and early neurodevelopment were extracted, and quality was assessed through scales specific to study design. Results Starting from 1689 retrieved records, 11 studies were included in the review, 9 (82%) cohort studies, 1 (9%) case-control study and 1 (9%) randomized controlled trial. All the studies were of moderate/good quality. Gut maternal and infant microbiota composition in early life appear to be closely connected to early neurodevelopment both in terms of cognitive/motor skills and temperament. NI has a significant influence in shaping these outcomes as it can alter microbiota balance and contribute to gut dysbiosis and delayed neurodevelopmental milestones. Breastfeeding emerges as a crucial factor in modulating infant microbiome and supporting neurodevelopment. Also, other factors such as pre-pregnancy overweight/obesity and environment seem to influence offspring gut colonization and neurodevelopmental outcomes. Conclusions This study highlights the intricate interplay between maternal and child NI, microbiota and early neurodevelopment. These findings underscore the critical need for targeted interventions addressing maternal and child nutrition to mitigate the adverse effects of NI and support optimal early-life neurodevelopment. Future research should focus on longitudinal studies to explore the causal pathways and to develop nutrition-based strategies to prioritize microbiome health in vulnerable and at-risk populations. Key messages • Addressing nutrition security through targeted public health interventions is critical for optimizing microbiome integrity and supporting neurodevelopment during critical early-life windows. • Understanding the intricate interactions between maternal and child nutrition, microbiome, and early neurodevelopment is crucial for developing targeted public health strategies and interventions.