Issue Highlights

A Swedish register study by Voss et al. [1] investigated whether advanced maternal age was associated with adverse neonatal outcomes, by comparing mothers aged 35–39 years to those aged 40–44 and 45 plus. Severe adverse neonatal outcomes were uncommon but were higher in the advanced and very advanced maternal age groups than the youngest group. These included stillbirths, preterm births, hypoglycaemia, infants being born small for gestational age, and Apgar scores below seven at 5 min. Using medication for attention-deficit hyperactivity disorder (ADHD) was associated with an increased risk of cardiac events in children and young adults. Elmowafi et al. [2] carried out a Swedish case–control study that used national register data to identify individuals aged 5–30 years who received their first diagnosis of a cardiac event. Undefined arrhythmias had the strongest association with ADHD medication, but no difference was seen when individuals with congenital heart disease were compared with controls. The Swedish Society of Paediatric Infectious Diseases worked with paediatric societies for emergency medicine, anaesthesia and intensive care to produce the 2025 recommendations for the initial management of suspected sepsis. They cover children from 28 days of corrected age to 18 years. A clinical overview by Malmgren et al. [3] presents the guidelines, including a flowchart for suspected paediatric sepsis, with or without shock, and a checklist for initial management. Meanwhile, Nordström Carlsson et al. [4] explored the accuracy of inflammatory biomarkers for ruling out invasive bacterial infections in young febrile infants. Gelander et al. [5] used computerised algorithms to compare the performance of growth assessment criteria recommended in Sweden with those used in Finland and established by the International Obesity Task Force. Historical data from 3214 Swedish children at 4, 6 and 8 years of age were compared with five Finnish screening parameters. The authors concluded that the Finnish algorithm could identify abnormal increases in the height and body mass index of Swedish children, using the country's own national growth references. The algorithm is stricter than the current cut-off criteria used in Sweden, and it remains to be seen whether these criteria would result in more accurate referrals. Using the diuretic drug bumetanide improved symptoms in 25%–30% of children with autism in a small waitlist-controlled study. Fernell et al. [6] focused on 15 children with autism, who were treated for two three-month periods, with one medication-free period. In a different view paper, Coleman et al. [7] say that it is time that child psychiatry and child neurology worked together. Meanwhile, a population-based study by Kanina et al. [8] found that an association between neonatal jaundice and autism was confounded by gestational age and birth weight. The authors say this highlights the need to consider perinatal factors in causal analyses.