The cytotoxic environment present in PE affects the development of fetal cell lineages. Neutropenia is observed in 50% of neonates and is correlated with mortality, although its treatment is not well-established. The enhancement in erythropoietin and the hypoxic setting present in the disease can also lead to thrombocytopenia. Per partum management includes platelet transfusion in order to avoid severe complications such as intraventricular hemorrhage. Regarding other cell lines, a cytotoxic profile is observed to be reflecting the milieu present in the mothers' bloodstream. This disruption alters the immune system response into a proinflammatory profile and can be correlated to neonatal necrotizing enterocolitis. An antiangiogenic environment is also part of the preeclampsia presentation and can be responsible for the enhancement of bronchopulmonary dysplasia observed in this population. Meanwhile, the reduction in angiogenic factors, such as vascular endothelial growth factor (VEGF), can be a protective mechanism for retinopathy of prematurity. Studies of the long-term effects of these observations are lacking, but lower neurodevelopmental scores and a higher cardiovascular risk are noted. New treatments in research propose a prevention of the disease during gestation in order to reduce the effects more efficiently in the fetus. Phosphodiesterase inhibitors, endothelin 1 receptor antagonists and manipulation of heme oxygenase-1 enzyme pathway are possible therapeutic alternatives. This review summarizes the current understanding of how preeclampsia affects neonates. As a conclusion, further studies are needed to build up a guideline to manage those effects. A research agenda is proposed.

Besides being useful to predict hospital death, CRIB was a simple score to be applied. Based on these results, we recommend its inclusion in the routine of neonatal units.

Background The bioelectrical impedance (BI) phase angle (PA), analyzed directly through BI analysis (BIA), is determined by tissue cellularity, representing a direct measure of cellular stability and, for this reason, has been studied and considered as an indicator of prognosis and nutrition status in adults and children. Objective We aimed to determine if PA can be an indicator of mortality and prognosis in newborns admitted to the neonatal intensive care unit (NICU). Methods Transversal study conducted at a public NICU in Curitiba, Paraná, Brazil. All newborns, preterm and term, were considered eligible for the study if admission to the NICU occurred by the first hour of life. The Score for Neonatal Acute Physiology II, as well as the Perinatal Extension version, were developed to assess the risk of mortality for all newborns, measured within 12 hours of admission. BIA measurements were conducted using the tetrapolar BioScan Maltron 916, with single‐frequency (50 kHz) tetrapolar BI. PA was calculated as the arc tangent: (Xc/R) x 180°/π. Results BIA was measured during the first 24 hours of admission for all newborns (n = 93), repeated between 24 and 48 hours (n = 79) and again after 7 days (n = 55), always when possible. PA measurements decreased in the first 48 hours in premature newborns, particularly among those who died. The premature newborns also showed a significant decrease from the first to the last PA measurement (P = .001). In addition, whereas full‐term newborns showed an increase of PA at 1 week of life, preterm infants continued to have a decrease in values. For preterm newborns, PA measurements decreased and more sharply so for those who died. This result should be viewed with caution given the small number of deaths, but it should be investigated to understand the role of PA in the prognosis of NICU newborns. Conclusions The absolute value of PA during the first 24 hours of life was not a good marker for severity or mortality. However, the decrease of PA between different moments of evaluation was a good marker of severity. The decrease of PA in the first 48 hours in premature newborns, and that when the decrease is more pronounced, may be indicative of mortality. The difference in PA values between these newborns is probably a significant variable for mortality and prognosis and not a cutoff value.

INTRODUÇÃO: A terapia com oxigênio suplementar reduz quadros de hipóxia reduzindo a mortalidade entre recém-nascidos prematuros (RNPT), porém, a excessiva exposição ao oxigênio, tem o potencial de atingir e danificar múltiplos órgãos do neonato. Objetivo: Determinar os fatores associados ao uso de suporte ventilatório/oxigenoterapia nos RNPT. MATERIAIS E MÉTODOS: Estudo observacional, longitudinal, prospectivo de caráter quantitativo, realizado no período de julho de 2019 a março de 2020, em unidade de terapia intensiva neonatal (UTIN) de um hospital público universitário. Foram observados RNPT em uso de oxigenoterapia, desde o período de admissão até a alta, sendo coletados  dados gestacionais, de nascimento e parâmetros da oxigenoterapia. RESULTADOS: 62 RNPT foram acompanhados com média de idade gestacional (IG) de 30,5 semanas (±3,43) e mediana de peso ao nascimento (PN) de 1.390 gramas (555 g - 3.115 g). O tempo médio de internação de 35 dia (3-176) e de oxigenoterapia foi de 7,5 dias (1-176). Ao relacionar o total de dias em oxigenoterapia com o valor do Apgar no 5º minuto, não houve relação significativa (rho= -0,158; p=0,219), porém, houve relação com a IG ao nascimento (rho= -0,725; p<0,001), uso de corticoide antenal (p=0,006) e surfactante exógeno (<0,001). Houve relação também com displasia broncopulmonar (DBP) e retinopatia da prematuridade (ROP) (p<0,001). CONCLUSÃO: Os fatores associados ao tempo e uso de oxigenoterapia foram a IG, PN, uso de corticoide antenal e surfactante exógeno, sendo observado também associação com DBP e ROP.

No abstract