Neonatal mortality remains a major health challenge across the world, which involves neonatal sepsis and other related factors of prematurity. Though many strides have been done in reducing NMR, there is a need for more appropriate interventions and strategies directed towards addressing the rise in the escalation of AMR. Combating AMR will be critical in improving neonatal survival rates while giving each newborn a healthier start into life globally.

The newborn period is the key period for infant health, and the first 28 days of life are critically important-both for survival and as a base to set lifetime health and development. Neonatal deaths globally have witnessed a significant decline over the past couple of decades. The neonatal mortality count has significantly reduced dropping from a high of 5 million in 1990 to as low as 2.3 million as of 2022. However, this decline notwithstanding, neonatal mortality is still staggeringly high across low-and middle-income nations.

Neonatal mortality rates are 22 per 1000 live births in India. Neonatal sepsis and prematurity are the main causes of neonatal deaths in these tragic events. Recognizing the gravity of the issue the Indian government started the Indian Newborn Action Plan (INAP) in 2014. The goal is to take NMR down to the single digits by 2030. This initiative has brought in several key interventions, including antenatal care (vaccines, micronutrient supplementation), skilled birth attendance, clean birth practices, and neonatal resuscitation techniques. More promisingly, postnatal interventions, including early initiation of breastfeeding and skin-to-skin contact, have been proven to work well in improving newborn survival rates.

Despite these improvements, one of the biggest concerns in neonatal care today is the growing problem of antimicrobial resistance (AMR) which seriously threatens efforts to reduce neonatal mortality.

What is Antimicrobial Resistance?

Antimicrobial resistance occurs when microorganisms such as bacteria, viruses and fungi evolve over time and become resistant to commonly used antibiotics and other medications. This resistance makes infections more difficult to treat, increasing the risk of mortality and complicating treatment options. The World Health Organization has classified AMR as one of the most urgent global health threats since it not only causes death and disability but also places immense pressure on healthcare systems, significantly raising the economic burden.

The sources of AMR are many, including poor hygiene and infection control in healthcare settings, overuse and misuse of antibiotics. Contributing factors to this rapidly growing problem are antibiotic prescriptions for patient needs that do not require them and failure to complete antibiotic courses, as prescribed.

AMR and Newborn Health

For neonates, the risk is much more vital for AMR. Neonates are particularly prone to developing infections due to their rather weak immune systems. Neonatal sepsis, severe bacterial infection, is one of the leading causes of neonate deaths and it often manifests complications when it is because of drug-resistant pathogens.

According to Dr. Apoorva Taduri, Consultant Neonatologist, "Neonatal sepsis accounts for a significant proportion of neonatal deaths, and AMR is making it worse. MDR pathogens cause around 30% of neonatal sepsis mortality globally.

Maternal health and care are also factors influencing AMR in neonates. Over-prescription of antibiotics during pregnancy increases the risk of neonatal sepsis and the development of multi-drug-resistant pathogens in newborns. This calls for prudent use of antibiotics during pregnancy and at the time of delivery. In fact, studies indicate that indiscriminate use of antibiotics in mothers has a direct impact on neonatal health, which may eventually lead to resistant infections in newborns.

One of the major issues is that the drug-resistant bacteria are causing an increasing number of healthcare-associated infections in the neonatal care settings, which include NICUs. Infections by such bacteria prove to be challenging to treat; they require more advanced, expensive interventions, and the period of risk of mortality and morbidity is extended.

Counteracting AMR in Neonatal Care

To combat AMR and reduce neonatal mortality a multifaceted approach is necessary. Dr. Taduri emphasizes the continuation of the strategies outlined by the Indian Newborn Action Plan (INAP), specifically in reducing neonatal sepsis and improving infection control. However, to combat AMR more must be done to ensure proper use of antibiotics in both maternal and neonatal care settings.

Key strategies for reducing AMR in neonatal care are:

1. Improving Infection Prevention Practice: This implies, therefore, that more efforts would be made regarding stricter hospital hygiene standards, strict equipment sterilization after its usage and even maintaining adequate hand hygiene. Enhanced infection control practices greatly impact minimizing AMR pathogens distribution.

2. Antibiotic Stewardship- Teaching the healthcare providers how not to use antibiotics is a crucial thing in preventing overuse prescription. Antibiotic stewardship programs are designed to promote use of antibiotics only when truly required; appropriate drug, dose and length of treatment should be taken.

3. Improved access to WASH: Access to clean water and sanitation is a fundamental aspect of preventing infections in mothers and newborns. WASH interventions such as clean birthing practices, can reduce the risk of neonatal sepsis due to unsanitary conditions.

4. Maternal Health Strengthening: Proper maternal care, such as proper vaccination, antenatal steroids, and supplementation of micronutrients, can reduce the risk of prematurity and neonatal infection. Prevention of infection in mothers is the first step towards prevention of infection in newborns.

5. Early Diagnosis and Treatment: Early identification and treatment of neonatal infections are very important. This includes proper screening for sepsis and the use of appropriate antibiotics based on the local resistance patterns. It also involves ensuring that infants receive adequate neonatal care, such as those provided in Special Newborn Care Units (SNCUs).

The rise of antimicrobial resistance is a global health challenge that requires urgent action. Combating AMR requires a coordinated effort from governments, healthcare systems and communities worldwide. In neonatal care, addressing AMR is essential to further reducing neonatal mortality rates and ensuring that every newborn has the opportunity to thrive.

As Dr. Taduri concludes, "While we have made substantial progress in reducing neonatal mortality, the emerging risk of antimicrobial resistance creates a major challenge for our efforts. Combating AMR requires a global collective effort, with priorities on infection prevention, responsible use of antibiotics, and enhancement of healthcare practices to ensure a healthier future for all newborns."

Dr Apoorva Taduri is a Consultant Neonatologist at Fernandez Hospital

Women with hypertensive disorders in pregnancy face a higher risk of death, while their babies are also at risk of serious illness and mortality, according to the World Health Organization (WHO).

Hypertensive disorders in pregnancy, which include pre-eclampsia and eclampsia, affect millions of women every year and complicate an estimated 10–15% of pregnancies worldwide. They account for around 16% of maternal deaths globally, resulting in an estimated 42,000 deaths each year, as well as more than 500,000 stillbirths and newborn deaths.

“Pre-eclampsia can develop in any pregnancy. Whether it becomes fatal depends on whether a woman's blood pressure was checked in time, and whether quality emergency care was within reach when it turned severe,” said Dr Pascale Allotey, Director of WHO’s Department of Maternal, Child, Adolescent Health.

WHO Launches Global Roadmap

Also read: 16 Million Indians Die Due To Hypertension Every Year: AIIMS Doc

To tackle hypertensive disorders of pregnancy, WHO today launched a new global roadmap at the Society for Maternal-Fetal Medicine Global Conference.

The roadmap brings together research, medicines, clinical guidance, health systems and political action so that a woman’s chances of surviving pregnancy and having a baby do not depend on where she lives.

It highlights a gap between the scale of the problem and the lack of medicines specifically developed and approved by regulators to prevent or treat pre-eclampsia or eclampsia.

Research investment has largely focused on diagnostics, with chronic underinvestment in new preventive and treatment options.

The roadmap also addresses gaps in blood pressure checks, medicines and emergency care. In many countries, women still lack reliable access to basic blood-pressure measurement, urine protein testing and essential medicines, including aspirin, antihypertensives and magnesium sulfate.

Weak referral systems, shortages of trained health workers and limited emergency obstetric services can further delay life-saving care.

Read More: World Heart Day: You Feel Healthy. But Plaque May Already Be Building In Your Arteries In Your 20s

Women In Poorer Countries Face Higher Risks

In low- and middle-income countries, gaps in antenatal care, medicines, diagnostics, trained health workers and emergency services mean women are more likely to develop severe complications or die.

Women affected by poverty, humanitarian crises, geographic isolation and other challenges face particularly high risks.

How Pregnancy Hypertension Affects Mothers And Babies

READ: Rare Pregnancy Infections Linked To 3-Fold Higher Autism Risk: What Is TORCH?

Hypertensive disorders in pregnancy include:

• Chronic Hypertension: High blood pressure before pregnancy or before 20 weeks.
• Gestational Hypertension: New high blood pressure after 20 weeks without protein in urine.
• Preeclampsia-Eclampsia: High blood pressure after 20 weeks with protein in urine or organ damage; eclampsia involves seizures.
• Superimposed Preeclampsia: Preeclampsia developing in a woman with chronic hypertension.

Pre-eclampsia and eclampsia are major causes of maternal death and severe illness worldwide. They contribute to stillbirth, preterm birth, newborn mortality and morbidity, and health-system costs.

Pre-eclampsia can also have consequences for mothers long after childbirth. Women affected by hypertensive disorders of pregnancy face increased risks later in life of chronic hypertension, cardiovascular disease, stroke and kidney disease.

Children exposed during pregnancy can face increased risks associated with preterm birth and longer-term cardiovascular and metabolic disease.

WHO Calls For Coordinated Action

WHO is asking governments, funders, researchers, health professionals, industry, civil society and development partners to align investment and action around one goal: ensuring that proven interventions and future innovations reach the women and babies who need them most.

The WHO roadmap sets a shared vision and coordinated actions across five areas: research and innovation; norms and standards; access to health products; implementation; and advocacy and accountability.

It aims to accelerate progress towards ending preventable maternal and newborn mortality and morbidity and stillbirth associated with hypertensive disorders, while contributing to SDG targets 3.1 and 3.2.

The effects childhood obesity could extend into adulthood. Similarly, a person's fitness level as a kid could have a significant impact on their wellbeing, especially mental health. New research suggests there may be a link.

A study led by researchers at the University of Tasmania’s Menzies Institute for Medical Research found that children and adolescents with better cardiorespiratory fitness were less likely to develop depression as adults. The findings, published in the Journal of Affective Disorders, are based on more than 30 years of follow-up.

Study Conducted Over A Span Of 30 Years

Also read: WHO Cautions Against GLP-1s As First-Line Treatment For Childhood Obesity, Prioritises Lifestyle Changes

Researchers studied data from the Childhood Determinants of Adult Health Study, which began in 1985. More than 1,000 Australian participants were assessed when they were between 7 and 15 years old and followed into adulthood, when they were aged 36 to 49.

Childhood fitness was assessed using physical tests including a 1.6-kilometre run, which measured cardiorespiratory fitness, and a standing long jump to assess muscular power.

A smaller group also underwent tests of muscular strength and fitness using a cycle ergometer. More than three decades later, participants completed a World Health Organization diagnostic interview to assess depression.

The strongest and most consistent association was between cardiorespiratory fitness and lower risk of depression later in life. The relationship appeared stronger among females, while the links involving muscular fitness were less consistent.

Dr Brooklyn Fraser, a researcher at the Menzies Institute, said the study offered a rare opportunity to examine the relationship across such a long period.

“The data collected over 30 years has given us a rare opportunity to examine how early-life fitness relates to mental health later in life,” Fraser said. “We found that children and adolescents with better cardiorespiratory fitness had a lower risk of developing depression as adults.”

Fitness In Childhood Linked To Mental Health Decades Late

Also read: Sedentary Lifestyle Linked To Rise In Back Pain Among Indian Schoolchildren, Say Experts

The study does not establish exactly why childhood fitness was associated with better mental health later in life. But one possibility is that cardiorespiratory fitness reflects a combination of physical activity, cardiovascular health and other behaviours that can influence mental wellbeing. Staying active during childhood may also contribute to healthier habits that persist into adulthood.

Exercise itself has been linked with several aspects of better mental health, including mood, sleep and stress regulation. Social interaction through sports and physical activity could also play a role. But researchers caution against reducing depression to a single lifestyle factor.

“There are many contributing factors to depression, meaning no single factor explains risk on its own. Fitness may be one piece of the puzzle,” said Dr Kylie Smith, the study’s lead author.

The researchers measured fitness at one point in childhood and then examined depression decades later. Factors throughout those intervening years, including genetics, social circumstances, physical health, stress, lifestyle and other experiences, can all influence depression risk.

“While we cannot say a lack of fitness during childhood causes depression in adults, the findings suggest that childhood fitness may have benefits beyond physical health,” Smith said.

A 2026 review and meta-analysis involving more than 4 million people found that higher cardiorespiratory fitness was associated with a lower risk of depression in adults.

The study adds to evidence supporting opportunities for children to move regularly, play outdoors, participate in sports they enjoy and build fitness. Professor Grant Tomkinson of Adelaide University said fitness is important because it is something that can be changed.

“We already know that being physically active is good for our mental health, and previous research has shown that fitter adults are less likely to develop depression,” Tomkinson said. “But we know relatively little about whether being fit early in life is linked to better mental health decades later.”

The World Health Organization has issued its first global guidelines for tackling obesity in children and adolescents. Prioritising lifestyle changes, it has placed diet, physical activity and behavioural support ahead of clinical weight-loss treatments like GLP-1 drugs.

The guidelines come as obesity poses a greater threat to children and adolescents. In 2024, around 400 million children and adolescents aged 5 to 19 were overweight, including 170 million living with obesity. The rate of obesity in this age group has quadrupled since 1990, jumping from 2% to 8%.

The WHO's recommendations come amid growing use of GLP-1 drugs like Wegovy and Saxenda among younger patients in some countries.

The use of GLP-1 medications weight-loss medications among children under 12 in the US has risen in recent years. According to a recent research data, in 2019, only about 0.03% of children had been prescribed a GLP-1 drug like Wegovy and Saxenda, made by Novo Nordisk, and Eli Lilly's Zepbound. By June 2026, that figure had risen to 9.3%.

WHO Does Not Recommend GLP-1s For Children Under 10

Also read: Are GLP-1 Drugs Safe for Children? Study Finds Nutritional Deficiency in Nearly 17% Within a Year

WHO does not recommend weight-loss medicines, bariatric surgery or weight-management devices for treating obesity for children aged 0 to 9 years.

Instead, it recommends lifestyle interventions, including dietary changes, physical activity and behavioural programmes for children and their caregivers. WHO's guidelines are linked to the limited evidence available on the long-term safety and effectiveness of obesity medicines in younger children.

The guidance is more nuanced for adolescents aged 10 to 19, the. Approved obesity medicines, including GLP-1 therapies, may be considered when a supervised, structured lifestyle programme fails to achieve the desired results.

This means the WHO is not ruling out medication for teenagers but does not place it ahead of lifestyle changes.

“The foundation of obesity care for children and adolescents is not medicine or surgery, but access to comprehensive support that enables healthy eating, physical activity and sustainable behaviour change,” said Luz María De Regil, director of WHO's Department of Nutrition and Food Safety.

Why Is WHO Cautious About GLP-1 Drugs For Children?

Also read: Wegovy & Zepbound Are Not Approved By US FDA For Children Under 12: So Why Are Prescriptions Rising?

GLP-1 medicines like Ozempic, Mounjaro and Wegovy have transformed obesity treatment in adults, but the evidence base in children and adolescents is limited. De Regil said there is currently insufficient evidence on GLP-1 drugs in younger populations. The WHO director also said that research is in progress to study their effectiveness and safety, which could revise the health body's position.

Questions around long-term safety, how treatment affects growth and development, how long medication needs to be continued and what happens after stopping treatment remain important areas of research. It's crucial as children may have to be on GLP-1 treatment for a long time.

Some GLP-1 drugs are already approved for certain younger patients. In the US and European Union, Wegovy and Saxenda can be used for weight management in some adolescents aged 12 and older, while the EU also permits Saxenda for certain children aged 6 to 11.

Even though evidence is limited about side-effects of GLP-1 drugs in children, a new study found that nearly 1 in 6 children, or 17%, treated with GLP-1 medications developed a diagnosed nutritional deficiency within one year.

The research, conducted by scientists at Northwestern University and Ann & Robert H. Lurie Children’s Hospital of Chicago, found that vitamin D deficiency was the most common nutritional deficiency, identified in 12.4% of children within one year of starting GLP-1 treatment.

WHO Wants Obesity Treatment To Go Extend Weight Loss

The new guidelines also emphasise that treating childhood obesity should not be reduced to the weighing scale. WHO recommends addressing diet, physical activity, sedentary behaviour, sleep and behavioural factors, while tailoring interventions to the child and family.

Mental health also forms part of the guidance as anxiety, depression, low self-esteem and social withdrawal can both contribute to unhealthy behaviours and be consequences of living with obesity. Children with obesity can also face stigma and bullying, making psychological and social support an crucial part of obesity care.

“Our priority must be to ensure that every child and adolescent can access quality care and supportive environments from an early age, helping them achieve and maintain a healthy weight and laying the foundation for lifelong health and well-being,” De Regil said.