Efficient production of heifers is fundamental to the productivity and sustainability of dairy farms. However, high pre-weaning morbidity and mortality rates are frequently reported worldwide, imposing substantial welfare and economic implications. A major contributing factor to disease susceptibility in the neonatal stage is the inability of calves to mount an effective immune response. Several stresses imposed on the late gestation cow can compromise intrauterine conditions during critical periods of the offspring’s development. These downstream carry-over effects cannot only adversely affect calf growth, but also impair immune capabilities that can lead to increased disease susceptibility. For example, pre-weaning metabolic function and growth are associated with future milk production. Thus, late-gestation carry-over effects span into the lactating stage of the heifers. This presentation will review the effects of maternal stress during late-gestation on the offspring’s growth, productivity, metabolism, and immune function. In addition, strategies focusing on maternal interventions to improve neonatal health will be discussed. A better understanding of the intrauterine conditions affecting calf health and development may facilitate the design of management practices that could improve neonatal development and future cow productivity.