Introduction: Neonatal menstruation is considered the most neglected uterine bleeding, but it was concluded to be a marker of fetal stress. It is more common in preeclampsia, fetal growth restriction, and isoimmunization.¹ It has a prevalence of 5% in healthy newborns, which is lower in preterm newborns and higher in low birth weight newborns.² Case description: A 6-days-old female born with 41 weeks of gestation presented a 2-day history of vaginal bleeding without other symptoms or history of trauma. Physical examination evidenced vaginal bleeding, without external lesions (fig.1). Complementary diagnostic tests were not performed. Following vigilance, vaginal bleeding was present for 6 days and stopped on the 10th day of life. Discussion: Vaginal bleeding in the neonatal period results from desquamation of the endometrium, triggered by the decline in circulating steroid hormones. It often begins 3 to 5 days after birth and typically lasts up to 10 days³ - a chronology similar to the case presented. Some newborns with neonatal menstruation experience retrograde menstruation, which causes implantation of endometrial cells in the abdominal cavity, which may lead to an increased risk of early endometriosis. Newborns who have this complication should be evaluated so that an early diagnosis of endometriosis can be made in the future in children who begin with pelvic pain or severe menstrual pain.

BackgroundThe coronavirus disease 2019 outbreak has led to social isolation, with the potential to increase depressive symptoms, even at the pediatric age. Before the COVID-19 pandemic, the rate of depressive symptoms in large youth cohorts was 12.9% worldwide. AimsThis study aims to characterize the impact of the COVID-19 pandemic on the pediatric population's mental health. Materials and methodsThis was an observational, descriptive, and cross-sectional study conducted through the use of a questionnaire, including the Children's Depression Inventory (CDI), between April 5 and May 5, 2021. The study was conducted on children and adolescents aged 7 to 17 years old in a school in the geographical area of a Portuguese grade II hospital. Incomplete data were excluded. Data were statistically analyzed using the IBM SPSS® program (version 28; IBM Corp., Armonk, NY), considering statistical significance if p<0.05. ResultsA total of 228 children and adolescents were included; 113 were female (49.6%). The average age of the population was 12.2 years. Fifteen point four percent (15.4%) had depressive symptoms, of which 51,9% were female. Of the children and adolescents with depressive symptoms, 5.7% had a personal history of past COVID-19 infection and 42.9% had at least one family member with a history of past COVID-19 infection. Seventeen point one percent (17.1%) had at least one family member involved in pandemic-related work. Children and adolescents who were infected with COVID-19 had more depressive symptoms than noninfected children and adolescents (p=0.013). At the same time, children and adolescents, with at least one family member with a history of past COVID-19 infection, had more depressive symptoms than children and adolescents without a family history of past COVID-19 infection (p=0.004). Children and adolescents with a family member involved in pandemic-related work had more depressive symptoms than children and adolescents without any family member involved in pandemic-related work (p=0.004). ConclusionsCOVID-19 infection, whether personal or familiar, has an impact on mental health, even in the pediatric age, and it is imperative to know the consequences of emotional and mental changes in this population.