Highlights in this issue


Caesarean section – impact on mother and child

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On pp. 1518–1522, Theodora Boutsikou and Ariadne Malamitsi-Puchner tell us the incredible story of Ines Ramirez Perez who, alone in a rural Mexican village caesarean sectioned herself fearing a possible loss of her baby. Whereas this true tale ended successfully, the authors raise concerns about the continued increase in primary elective caesarean sections (CS). Besides maternal complications, infants born by CS have more respiratory problems, altered gut colonization and divergent immune system development with increased risk for asthma and juvenile diabetes. They conclude that there is a need for evidence-based counselling before decision for primary CS.

Pros and Cons of a miraculous drug for ROP

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Retinopathy of prematurity (ROP) is a major cause of visual impairment in children. It is partially caused by abnormal angiogenesis in the retina. Therefore, it is logical to try to block the effects of the vascular endothelial growth factor (VEGF). Bevacizumab (Avastatin®) blocks the VEGF-induced angiogenesis and is marketed as a new effective drug against ROP. However, there is a lack of safety studies according to Anna-Lena Hård and Ann Hellström (pp. 1523–1527). Bevacizumab enters circulation, suppresses plasma VEGF levels and remains in the blood for more than 8 weeks in primates. Since VEGF is critical for growth and development of vital organs, the authors suggest that infants who can be treated successfully with laser should not receive Avastin®. See also article by Margareta Hök et al. (pp. 1528–1533).


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Norwegian children are less obese than other European children. Bente Brannsether et al. (pp. 1576–1582) report the waist circumferences and waist-to-height rates in 4–18-year-old children. The Norwegian children are more active practicing outdoor activities such as hiking or skiing. See also article by Peter Breithaupt et al. reporting about body scan methodology as an alternative to full-body analysis of percent fat, total mass, fat mass, lean mass, etc. (pp. e260–e266).

Early fish introduction lowers the risk of preschool wheeze

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It has previously been reported that early introduction to fish have beneficial effects on asthma, eczema and allergic rhinitis. In a prospective cohort study, Emma Goksör et al. found that fish introduction before 9 months of age also reduces the risk of recurrent wheeze at preschool age. In the same study, an increased risk for preschool wheeze was seen in children treated with antibiotics during the first week of life (pp. 1561–1566).

Long-term effects of early Kangaroo Mother Care

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Earlier-initiated continuous Kangaroo Mother Care (KMC) resulted in a significantly higher proportion of exclusive breastfeeding babies at 6 months postbirth when compared with later continuous KMC. This long-term follow-up trial was performed by Shuko Nagai et al. on 72 low-birth-weight infants in Madagascar. The early KMC was initiated as soon as possible within 24-h postbirth (pp. e241–e247).