[High levels of overweight and obesity in four year olds in Sweden]. / Övervikt och fetma kvar på höga nivåer bland 4-åringar i Sverige.

Childhood obesity is an increasing global health problem. Prevention and early treatment is crucial. The Swedish child health care targets almost all children and iso-BMI is assessed from the age of two. National reports on the prevalence of obesity are scarce. In this report data from the Swedish child health care on 105 445 four year olds was collected. Overweight (9 %) and obesity (2 %) was registered in 11 % of the children, which is in line with earlier, smaller, reports. More girls than boys were overweight or obese.  To improve the situation, the problem needs to be addressed by the entire society. Further evidence-based methods on prevention and early treatment need to be established. The Swedish child health care registry will enable follow-up on prevalence data.

Born too small: who survives in the public hospitals in Lilongwe, Malawi?

OBJECTIVE: Malawi has the highest estimated preterm birth rate in the world. The survival rate of these babies is not known. The main objective of this study was to demonstrate the short-term survival of infants with birth weight below 2500 g nursed in Bwaila Hospital, a district hospital, and the tertiary level Kamuzu Central Hospital (KCH) in Lilongwe. The specific objectives were to calculate birth weight specific survival rates, compare the two hospitals regarding the chances of survival and review the use of antenatal corticosteroids. DESIGN: 1496 babies were included prospectively in the study between June and November 2012. Survival was defined as discharge from the nursery or postnatal ward. RESULTS: Survival was 7% for extremely low birth weight infants, 52% for very low birth weight and 90% for low birth weight (1500-2499 g). There was a marked increase in survival from 1100 g. Survival was significantly higher in KCH only for babies weighing below 1200 g. The majority of deaths occurred within the first 3 days of life. Only 98 of the babies had a mother who had received antenatal corticosteroids. CONCLUSIONS: With the current resources, we suggest focusing efforts on preventing early neonatal deaths in low birth weight infants above 1100 g in the hospitals in Lilongwe. The coverage of antenatal steroids for mothers at risk of preterm delivery can be improved. Further studies are needed on the quality of the obstetric and neonatal care at the hospitals and how to reduce the high rate of preterm birth in Malawi.