A simple instrument to assess the risk of falling in postpartum women: the SLOPE scale (riSk of faLling in pOstPartum womEn)

The purpose of this study was to introduce a novel instrument aimed at stratifying the risk of falling in postpartum patients. The research was a survey of a sample of 460 midwives working at different hospitals, mainly in Northern Italy, except for a hospital in Rome (Italy). The survey, consisting of 70 items, was conducted among midwives and asked them to express their opinion regarding the increased risk of falling in puerperal women on a Likert scale according to the characteristics listed in the questionnaire. Items were derived from the synthesis of scales available in the literature from settings other than the postpartum period, and interviews were conducted with midwives with great experience in this area. A shortened version was obtained using principal component analysis. A 30-item final scale was obtained, the SLOPE (riSk of faLling in pOst-Partum womEn), ranging from 0 to 100. The scale allows stratification of postpartum women at low (0-10), intermediate (10-20) and high risk (>20) of falling. The development of the SLOPE scale is the first step towards more rational evidence-based management of the risk of falling in postpartum women in current clinical practice.Impact statementWhat is already known on this subject? Falls occurring in the postnatal period are not limited to women because infants are often involved in this adverse event, with several significant consequences. There is a lack of information on this issue due to the absence of both registries and scales for the prevention of falls.What do the results of this study add? The main result of this study is the development of a novel scale to assess the falling risk in postpartum women.What are the implications of these findings for clinical practice and/or further research? The development of this novel scale, even if based on midwives' experience and not on patients' data, is a first step towards a more rational evidence-based management of the risk of falling in postpartum women.

Mother-to-Infant Microbial Transmission from Different Body Sites Shapes the Developing Infant Gut Microbiome

The acquisition and development of the infant microbiome are key to establishing a healthy host-microbiome symbiosis. The maternal microbial reservoir is thought to play a crucial role in this process. However, the source and transmission routes of the infant pioneering microbes are poorly understood. To address this, we longitudinally sampled the microbiome of 25 mother-infant pairs across multiple body sites from birth up to 4 months postpartum. Strain-level metagenomic profiling showed a rapid influx of microbes at birth followed by strong selection during the first few days of life. Maternal skin and vaginal strains colonize only transiently, and the infant continues to acquire microbes from distinct maternal sources after birth. Maternal gut strains proved more persistent in the infant gut and ecologically better adapted than those acquired from other sources. Together, these data describe the mother-to-infant microbiome transmission routes that are integral in the development of the infant microbiome.

Maternal inheritance of bifidobacterial communities and bifidophages in infants through vertical transmission

BACKGROUND

The correct establishment of the human gut microbiota represents a crucial development that commences at birth. Different hypotheses propose that the infant gut microbiota is derived from, among other sources, the mother's fecal/vaginal microbiota and human milk.

RESULTS

The composition of bifidobacterial communities of 25 mother-infant pairs was investigated based on an internal transcribed spacer (ITS) approach, combined with cultivation-mediated and genomic analyses. We identified bifidobacterial strains/communities that are shared between mothers and their corresponding newborns. Notably, genomic analyses together with growth profiling assays revealed that bifidobacterial strains that had been isolated from human milk are genetically adapted to utilize human milk glycans. In addition, we identified particular bacteriophages specific of bifidobacterial species that are common in the viromes of mother and corresponding child.

CONCLUSIONS

This study highlights the transmission of bifidobacterial communities from the mother to her child and implies human milk as a potential vehicle to facilitate this acquisition. Furthermore, these data represent the first example of maternal inheritance of bifidobacterial phages, also known as bifidophages in infants following a vertical transmission route.