Document Type : Review Article
                            
                        
                                                    Authors
                            
                                                            
                                                                            1
                                                                        Department of Microbiology and Laboratory Sciences, Faculty Medicine and Health Sciences, SIMAD University, Mogadishu, Somalia, 252                                
                                                            
                                                                            2
                                                                        1. Banadir Hospital, Mogadishu, Somalia.                                
                                                            
                                                                            3
                                                                        Blood Banking Unit, Banadir Hospital, Mogadishu, Somalia.                                
                                                            
                                                                            4
                                                                        Department Of Microbiology, Kogi State University, Anyigba, Nigeria                                
                                                            
                                                                            5
                                                                        Faculty of Medicine and Health Sciences, SIMAD University, Mogadishu, Somalia                                
                            
                                                                            
                        
                        
                            Abstract
                            Background: Antibiotics are frequently prescribed during pregnancy to manage infections that threaten maternal and fetal health. However, increasing evidence links in utero antibiotic exposure to neonatal antimicrobial resistance (AMR), raising concerns about its long-term consequences. This review examines the impact of maternal antibiotic use on neonatal AMR, focusing on microbiome disruption, resistance mechanisms, and clinical outcomes. Studies indicate that up to 30-50% of neonates exposed to maternal antibiotics harbor resistant bacterial strains, primarily through vertical transmission and selective pressure. These neonates face a 2- to 3-fold higher risk of infections, prolonged hospital stays, and limited treatment options. Epidemiological data confirm that prenatal antibiotic exposure correlates with a significant increase (up to 40%) in resistant pathogen prevalence. To mitigate these risks, antimicrobial stewardship in obstetric care is essential, incorporating targeted antibiotic use, alternative infection prevention strategies, and rapid diagnostic advancements. Ethical considerations further complicate prescribing practices, necessitating a multidisciplinary approach that balances maternal and neonatal health priorities. As neonatal AMR escalates globally, implementing evidence-based interventions and policy reforms is critical to safeguarding future generations.
                        
                        
                        
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