Perinatal exposure to ultraprocessed foods and its impact on maternal gut dysbiosis, placental inflammation, and neonatal immune programming: A systematic review
Downloads
HIGHLIGHTS
- Perinatal ultraprocessed food (UPF) exposure disrupts maternal gut microbiota composition, increasing pro‑inflammatory taxa and systemic endotoxemia.
- Placental immune activation and oxidative stress represent key mediators linking maternal diet to fetal immune and metabolic programming.
- Neonatal outcomes include altered regulatory T‑cell development, Th2 immune skewing, allergic sensitization, and early metabolic risk.
- Integrated dietary counseling, microbiota‑targeted interventions, and public health policies are urgently needed to mitigate transgenerational immune health risks.
ABSTRACT
Objective: To synthesize and critically evaluate evidence linking perinatal exposure to ultraprocessed foods (UPFs) with maternal gut dysbiosis, placental inflammation, and neonatal immune programming, and to identify translational implications for perinatal care.
Materials and Methods: A systematic narrative review was conducted following PRISMA 2020 guidelines, without PROSPERO registration. Literature searches of major databases (2000–March 2025) identified 1,845 records. After screening and eligibility assessment, 20 studies were included. Study quality was appraised using validated tools, and data were synthesized thematically into evidence domains covering maternal microbiota, inflammatory pathways, placental changes, and neonatal immune outcomes.
Results: Maternal UPF consumption was associated with gut dysbiosis characterized by reduced microbial diversity, increased pro-inflammatory taxa, and systemic endotoxemia. Elevated inflammatory biomarkers including lipopolysaccharide, interleukin‑6, tumor necrosis factor‑a, and C‑reactive protein were frequently reported. Limited placental studies revealed increased innate immune activation and oxidative stress. Neonatal immune alterations included regulatory T cell suppression, T helper 2 skewing, increased allergic sensitization, and metabolic programming changes. Evidence strength was highest for maternal gut dysbiosis and immune programming but limited for direct placental mechanisms. Translational opportunities include dietary counseling, microbiota-targeted interventions, and public health strategies aimed at improving maternal diet quality.
Conclusion: Perinatal exposure to UPFs adversely impacts the maternal gut–placenta–fetal immune axis. Integrated dietary interventions and population-level nutrition policies are urgently needed to mitigate downstream transgenerational immune risk.
Gurumurthy G, Agrawal DK. Impact of maternal ultra-processed food consumption and preterm birth on the development of metabolic disorders in offspring. J Pediatr Perinatol Child Health. 2025;9:68-84. https://doi.org/10.26502/jppch.74050214
Lu X, Shi Z, Jiang L, Zhang S. Maternal gut microbiota in the health of mothers and offspring: from the perspective of immunology. Front Immunol. 2024;15:1362784. https://doi.org/10.3389/fimmu.2024.1362784
Collado MC, Rautava S, Aakko J, Isolauri E, Salminen S. Human gut colonisation may be initiated in utero by distinct microbial communities in the placenta and amniotic fluid. Sci Rep. 2016;6:23129. https://doi.org/10.1038/srep23129
Talebi S, Mehrabani S, Ghoreishy SM, Wong A, Moghaddam A, Feyli PR, et al. The association between ultra-processed food and common pregnancy adverse outcomes: a dose-response systematic review and meta-analysis. BMC Pregnancy Childbirth. 2024;24:369. https://doi.org/10.1186/s12884-024-06489-w
Biagioli V, Matera M, Ramenghi LA, Falsaperla R, Striano P. Microbiome and pregnancy dysbiosis: a narrative review on offspring health. Nutrients. 2025;17:1033. https://doi.org/10.3390/nu17061033
Ben-Avraham S, Kohn E, Tepper S, Lubetzky R, Mandel D, Berkovitch M, Shahar DR. Ultra-processed food intake in pregnancy and maternal and neonatal outcomes. Eur J Nutr. 2023;62:1403-1413. https://doi.org/10.1007/s00394-022-03072-x
Mottis G, Kandasamey P, Peleg-Raibstein D. The consequences of ultra-processed foods on brain development during prenatal, adolescent and adult stages. Front Public Health. 2025;13:1590083. https://doi.org/10.3389/fpubh.2025.1590083
Carreira NP, Lima MC, Travieso SG, Sartorelli DS, Crivellenti LC. Fatores maternos associados ao consumo usual de alimentos ultraprocessados na gestação. Cien Saude Colet. 2024;29:e16302022. Portuguese. https://doi.org/10.1590/1413-81232024291.16302022
Naspolini NF, Machado PP, Moreira JC, Asmus CIRF, Meyer A. Maternal consumption of ultra-processed foods and newborn exposure to perfluoroalkyl substances (PFAS). Cad Saude Publica. 2021;37:e00152021. https://doi.org/10.1590/0102-311X00152021
de Oliveira PG, de Sousa JM, Assunção DGF, de Araujo EKS, Bezerra DS, Dametto JFDS, Ribeiro KDDS. Impacts of consumption of ultra-processed foods on maternal-child health: a systematic review. Front Nutr. 2022;9:821657. https://doi.org/10.3389/fnut.2022.821657
Wang Y, Wang K, Du M, Khandpur N, Rossato SL, Lo CH, et al. Maternal consumption of ultra-processed foods and subsequent risk of offspring overweight or obesity: results from three prospective cohort studies. BMJ. 2022;379:e071767. https://doi.org/10.1136/bmj-2022-071767
Puig-Vallverdú J, Romaguera D, Fernández-Barrés S, Gignac F, Ibarluzea J, Santa-Maria L, et al. The association between maternal ultra-processed food consumption during pregnancy and child neuropsychological development: a population-based birth cohort study. Clin Nutr. 2022;41:2275-2283. https://doi.org/10.1016/j.clnu.2022.08.005
Vieira E Souza RC, Miranda C, Maia de Sousa T, Dos Santos LC. Effect of ultra-processed foods consumption and some lifestyle factors during pregnancy on baby's anthropometric measurements at birth. Nutrients. 2022;15:44. https://doi.org/10.3390/nu15010044
Jang W, Kim M, Ha E, Kim H. Association of maternal ultra-processed food consumption during pregnancy with atopic dermatitis in infancy: Korean Mothers and Children's Environmental Health (MOCEH) study. Nutr J. 2024;23:67. https://doi.org/10.1186/s12937-024-00969-7
Silva CFM, Saunders C, Peres W, Folino B, Kamel T, Dos Santos MS, Padilha P. Effect of ultra-processed foods consumption on glycemic control and gestational weight gain in pregnant with pregestational diabetes mellitus using carbohydrate counting. PeerJ. 2021;9:e10514. https://doi.org/10.7717/peerj.10514
Sousa JM, Bezerra DS, Lima LVP, Oliveira PG, Oliveira NM, Araújo EKS, et al. Association of maternal consumption of ultra-processed foods with feeding practices and malnutrition in breastfed infants: a cross-sectional study. Int J Environ Res Public Health. 2025;22:608. https://doi.org/10.3390/ijerph22040608
Simões-Alves AC, Arcoverde-Mello APFC, Campos JO, Wanderley AG, Leandro CVG, da Costa-Silva JH, de Oliveira Nogueira Souza V. Cardiometabolic effects of postnatal high-fat diet consumption in offspring exposed to maternal protein restriction in utero. Front Physiol. 2022;13:829920. https://doi.org/10.3389/fphys.2022.829920
Rodrigues CAO, Andrade RES, Silva RRV, Brito MFSF, de Pinho L. Consumption of ultra-processed foods and its association with sociodemographic, clinical and nutritional characteristics by pregnant women assisted in the public health network. Psychol Health Med. 2025;1-18. https://doi.org/10.1080/13548506.2025.2519226
Morales-Suarez-Varela M, Rocha-Velasco OA. Impact of ultra-processed food consumption during pregnancy on maternal and child health outcomes: a comprehensive narrative review of the past five years. Clin Nutr ESPEN. 2025;65:288-304. https://doi.org/10.1016/j.clnesp.2024.12.006
Rodríguez-Cano AM, González-Ludlow I, Suárez-Rico BV, Montoya-Estrada A, Piña-Ramírez O, Parra-Hernández SB, et al. Ultra-processed food consumption during pregnancy and its association with maternal oxidative stress markers. Antioxidants (Basel). 2022;11:1415. https://doi.org/10.3390/antiox11071415
Copyright (c) 2025 I Nyoman Hariyasa Sanjaya, Wiku Andonotopo, Muhammad Adrianes Bachnas, Julian Dewantiningrum, Mochammad Besari Adi Pramono, Ryan Saktika Mulyana, Evert Solomon Pangkahila, Muhammad Ilham Aldika Akbar, Cut Meurah Yeni, Dudy Aldiansyah, Nuswil Bernolian, Anak Agung Gede Putra Wiradnyana, Adhi Pribadi, Sri Sulistyowati, Milan Stanojevic, Asim Kurjak
This work is licensed under a Creative Commons Attribution 4.0 International License.
1. Copyright of the article is transferred to the journal, by the knowledge of the author, whilst the moral right of the publication belongs to the author.
2. The legal formal aspect of journal publication accessibility refers to Creative Commons Attribution-Non Commercial-Share alike (CC BY-NC-SA), (https://creativecommons.org/licenses/by-nc-sa/4.0/)
3. The articles published in the journal are open access and can be used for non-commercial purposes. Other than the aims mentioned above, the editorial board is not responsible for copyright violation
The manuscript authentic and copyright statement submission can be downloaded ON THIS FORM.
