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ABSTRACT Introduction: The analysis of deaths occurred in the neonatal period and the association of these data to necropsy data are crucial to reduce infant mortality rate worldwide. Objective: To analyze the preventable causes of death and the factors associated with a higher risk of early newborn death. Methods: A cross-sectional and descriptive study was performed with data about newborns that died during the neonatal period at a university hospital located in Curitiba; 314 cases of pediatric necropsies were selected, and preventable causes of death, survival time, sex, weight, gestational age, first- and fifth-minute Apgar score, cyanosis, acidosis, meconium aspiration, the need for oxygen resuscitation, cause of death and baseline disease were analyzed. Results: When considering only the cause of death, 300 cases (95.54%) would have preventable causes, but when analyzing the underlying disease, the number of cases decreased to 209 (66.56%). The most frequent cause of death was hypoxia (85%), and the main baseline disease was diffuse alveolar damage (52.9%). There was a positive association between these variables with survival time: cyanosis (p = 0.02), gestational age (p = 0.012), cause of death (p < 0.001), Apgar score < 6 (p < 0.001) and pH value (p < 0.001). Conclusion: The incidence of preventable causes of death is probably lower when analyzed concurrently with the underlying disease. Cyanosis, gestational age, cause of death, Apgar < 6 and arterial blood pH are associated with survival time of newborns.

ABSTRACT Introduction: Despite the importance of cardiovascular diseases to population health, there is limited knowledge about how neonatal hypoxia, related or not with prematurity, may cause cell injury to cardiomyocytes in the neonatal period and what the consequences to adult life are. Objective: To analyze the tissue immunostaining of biomarkers involved in the process of cell death and growth in the myocardium of hypoxic newborns. Method: Human myocardium samples (left ventricle) from necropsies of hypoxic newborns were organized in multi-sample blocks and submitted to immunohistochemical reactions by the immunoperoxidase technique. The primary antibodies used were anti-B-cell lymphoma 2 (Bcl2)-associated X protein (BAX), anti-mitofusin-2 (Mfn2), anti-tumor necrosis factor receptor-associated protein 1 (TRAP1), anti-Bcl2, anti-angiotensin II, anti-serine/threonine (Akt) 1, anti-Akt2 and anti-Akt3. Tissue immunostaining data were correlated with clinical data (gender, weight, gestational age, first-minute and fifth-minute Apgar score, arterial blood pH and survival time) and pathological data (death cause and primary disease). Results: The average tissue immunostaining of BAX was 25.61%; TRAP1 was 7.86%, angiotensin II was 1.24%, Akt2 was 16.35% and Akt3 was 20.61%. The biomarkers Akt1, Mfn2 and Bcl2 presented very low or absent tissue immunostaining in most cases of this study. There was no correlation between the average biomarker tissue immunostaining and the survival time or any other clinical or pathological factor studied. Conclusion: These data seem to strengthen the coordinated action of the pro-apoptotic, anti-apoptotic and cell growth biomarkers in the myocardium of hypoxic newborns in order to determine the degree of lesion or cell death and the tissue recovery capacity.