Eight-month-old twins from Hayward Heath, West Sussex, recently met the surgeon who saved their lives even before they were born. The BBC reports how their mother, Katerina Ahouansou, at six months pregnant, during a routine scan, uncovered a serious issue with their development and blood supply.

Doctors diagnosed the twins with twin-to-twin transfusion syndrome or TTTS. It is a condition where one twin received more blood and nourishment than the other due to uneven blood vessel distribution in the placenta. In case there is no medical intervention, it could be fatal for both the twins.

A Specialist Steps In

This is when Ahouansou was referred to Professor Kypros Nicolaides at King’s College Hospital in London. Professor Nicolaides is a pioneer in fetal medicine and he specializes in a laser procedure that redistributes blood supply between twins in cases of TTTS.

When Ahouansou was scanned, Nicolaides observed that one of the twins were significantly smaller than the other. "There was a very high chance that if we did not intervene, both twins could die," he recalled.

An Operation No Less Than A Miracle

The life-saving laser surgery was performed and within a week the doctors saw an improvement with the twin who was smaller in size. When the twins were born, they weighed 1.5kg and 1.7kg. To recognize the efforts by the surgeon, Ahouansou named them Kai Kypros and Asher Nicolas after Professor Kypros Nicolaides.

Ahouansou also expressed deep gratitude for the professor's expertise and called him "proof that miracles can be performed by people who are devotees to their profession."

Professor Kypros Nicolaides has been at King’s College Hospital since 1980 and is widely regarded as a leader in fetal medicine. His groundbreaking research and development of screening and surgical techniques have saved countless lives.

Through his dedication, Professor Nicolaides has given many families hope, demonstrating how medical advancements continue to improve survival rates for complex fetal conditions like TTTS.

More about Twin-to-twin Transfusion Syndrome

As per the John Hopkins Medicine, TTTS is a rare pregnancy condition that affects identical twins or other multiples. It happens in pregnancies where twins share one placenta and a network of blood vessels that supply oxygen and nutrients essential for development in the womb. These pregnancies are known as monochorionic.

Sometimes, the blood vessels in the placenta are unevenly distributed, causing an imbalance in blood flow between the twins. The donor twin loses more blood than it receives, leading to malnutrition and potential organ failure. Meanwhile, the recipient twin gets an excess of blood, putting strain on the heart and increasing the risk of cardiac complications.

Impact on the Donor Twin

The donor twin loses blood volume (hypovolemia), reducing kidney function and urine production. This leads to low amniotic fluid levels (oligohydramnios) or, in severe cases, a complete absence (anhydramnios). Without proper blood circulation, the donor twin faces cardiovascular issues, increasing the risk of death.

Impact on the Recipient Twin

The recipient twin experiences excess blood volume (hypervolemia), causing increased urination and excessive amniotic fluid (polyhydramnios). The overworked heart struggles to handle the surplus blood, leading to cardiovascular dysfunction, heart failure, and, in extreme cases, death.

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.