Risks factors associated with intra-partum foetal mortality in pre-term infants

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Y axis: percentage of stillbirths (antepartum and intrapartum death) over the total number of births. X axis: gestational age in weeks." ] ] ] "textoCompleto" => "IntroductionFoetal mortality is a key indicator of perinatal care, and it accounts to up to 50% of perinatal mortality in countries such as the United States.<a class="elsevierStyleCrossRef" href="#bib0200">1</a> Preterm birth is one of the of the factors most strongly associated with foetal mortality, so that its analysis is recommended in preterm newborn studies.<a class="elsevierStyleCrossRefs" href="#bib0205">2,3</a> National registers do not always analyse this mortality, and comparisons between countries are hindered not only by differences in perinatal management practices, but also in the gestational ages included in the analysis.<a class="elsevierStyleCrossRefs" href="#bib0215">4,5</a> This may lead to the underestimation of foetal mortality, especially inpregnancies at the limit of viability.<a class="elsevierStyleCrossRef" href="#bib0225">6</a>The foetal mortality rate in developed countries is estimated at five to six per 1000 births,<a class="elsevierStyleCrossRef" href="#bib0230">7</a> and based on data from large-scale registers worldwide, the antepartum foetal mortality rate in the developed world is 5.2 per 1000 births and the intrapartum foetal mortality rate is 0.9 per 1000 births. In recent years there has been a decrease in intrapartum mortality, which may be due to more intensive antenatal care, improved monitoring during labour and an increased caesarean delivery rate.<a class="elsevierStyleCrossRefs" href="#bib0215">4,8</a> Numerous studies have analysed potential causes of foetal death in developed countries.<a class="elsevierStyleCrossRef" href="#bib0240">9</a> Foetal death seems to be a multifactorial phenomenon that is sometimes difficult to explain and with multiple aetiologies.<a class="elsevierStyleCrossRef" href="#bib0230">7</a> Several studies demonstrate that the risk factors associated with foetal death vary by gestational age and the timing of death, that is, whether it occurred before or during delivery.<a class="elsevierStyleCrossRefs" href="#bib0230">7,10–15</a> Since in developed countries intrapartum foetal death in preterm deliveries usually takes place in hospital settings, the detection of potential risk factors associated with it is of particular clinical relevance. However, we did not find any studies that specifically addressed perinatal factors that could potentially increase the risk of intrapartum foetal death in preterm births.The aim of this study was to analyse foetal mortality between 22 and 31+6 weeks’ gestation and to identify potential perinatal risk factors associated with intrapartum foetal death.Population and methodsPopulationWe conducted a study of pregnant women that gave birth preterm between 22 and 31+6 weeks’ gestation at the Hospital General Universitario Gregorio Marañón de Madrid (level IIIc referral hospital for high-risk pregnancies and congenital neonatal diseases).MethodsWe conducted a retrospective observational study over a period of seven years (January 2008 to December 2014). We collected the data recorded in the SEN 1.500 morbidity and mortality register prospectively. We collected data for the factors under study that are not recorded in this register prospectively between 2012 and 2014 and retrospectively for the 2008–2011 period. The study was approved by the Ethics and Clinical Research Committee of the Hospital General Universitario Gregorio Marañón.We applied the definitions of foetal death proposed by the WHO<a class="elsevierStyleCrossRef" href="#bib0275">16</a>: foetal death as death prior to the complete expulsion or extraction from its mother of a product of conception, irrespective of the duration of pregnancy, with no evidence of life (absence of breathing, heart beat, umbilical cord pulsation or movement of voluntary muscles); antepartum foetal death occurring prior to the onset of labour, and intrapartum foetal death as one in which the foetus was alive at the onset of labour. We completed the definition of intrapartum foetal death as absence of signs of life at minutes 1, 5 and 10 from birth (Apgar 0/0/0).We analysed the foetal mortality rate at 22 or fewer weeks’ gestation and between 23 and 31+6 weeks’ gestation (number of foetal deaths per 1000 births). Our centre is a level IIIc hospital that does not perform legal voluntary terminations of pregnancy, so cases of severe chromosomal disorders or malformations were included in the calculation of this rate.To analyse the cumulative incidence of foetal mortality between 23 and 31+6 weeks’ gestation (number of foetuses that died during this period compared to the total births in the same weeks of gestation) and the perinatal risk factors associated with intrapartum foetal death, we excluded cases with congenital anomalies and/or chromosomal disorders associated with poor survival rates (due to the increased risk of intrauterine death).The perinatal factors analysed in our study were: maternal age, prenatal care (from the beginning of pregnancy, that is, the full programme); disease preceding or during pregnancy, including preeclampsia, gestational diabetes, antepartum haemorrhage, unfavourable obstetric history (>2 previous miscarriages or cervical incompetence requiring cervical cerclage in the current pregnancy) and chronic disease (hypertension, diabetes mellitus type1, obesity, substance use, renal, hepatic, cardiovascular or autoimmune disease, or cancer); assisted reproductive technology (ART); multiple pregnancy; abnormal foetal ultrasound (intrauterine growth restriction [IUGR], abnormal Doppler, oligohydramniosorpolyhydramnios)<a class="elsevierStyleCrossRefs" href="#bib0280">17,18</a>; premature rupture of membranes and latency period in hours; antenatal administration of antibiotics; suspicion of chorioamnionitis<a class="elsevierStyleCrossRef" href="#bib0290">19</a>; antenatal administration of corticosteroids (number of doses and timing of administration relative to delivery); mode of delivery (vaginal or caesarean); gestational age (calculated on the basis of foetal ultrasound in the first trimester and date of last menstrual period, and in cases with no prenatal care, based on the physical examination of the newborn); birth weight, small for gestational age (birth weight<10th percentile)<a class="elsevierStyleCrossRef" href="#bib0295">20</a> and sex.Statistical analysisWe present the results of continuous variables as mean and standard deviation, and categorical variables as absolute frequencies and percentages. We have expressed quantitative variables that did not follow a normal distribution as median and interquartile range (25th–75th percentile).To compare the means of two groups, we used a parametric test (Student's t test) or nonparametric test (Mann–Whitney U test) as appropriate.We studied the association of mortality with qualitative variables by means of the chi square test or Fisher's exact test, and the association between quantitative variables by means of Pearson's correlation coefficient or Spearman's rho. We conducted a multivariate logistic regression analysis to identify potential factors associated with intrapartum death with a 95% confidence interval (CI). The statistical analysis was performed using SPSS® version 21.0 and EPIDAT 3.1. Results with a p-value of less than 0.05 were considered statistically significant.ResultsFoetal mortality (<a class="elsevierStyleCrossRefs" href="#tbl0005">Tables 1 and 2</a>)The mean foetal mortality rate at 22 to 31+6 weeks’ gestation was 2.3‰ (1.1–3.1‰). During this period, 63.1% (106/168) of foetal deaths took place in gestations of less than 32 weeks. (<a class="elsevierStyleCrossRefs" href="#tbl0005">Tables 1 and 2</a>).<elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0010"></elsevierMultimedia>In gestations of 22 to 31+6 weeks, the cumulative incidence of foetal mortality (excluding six foetuses with malformations and/or chromosomal disorders) was 11.3% (100/882; 95%CI, 9.2–13.8), with considerable variation based on gestational age (62.5% at 22 weeks’ gestation, compared to <10% at 29 or more weeks’ gestation). Intrapartum foetal death amounted to 2.6% of the total births (23/882; 95% CI, 1.5–3.7) and 23% of foetal deaths (23/100). Intrapartum foetal mortality was higher in gestations of less than 25 weeks, and reached 37.5% (3/8), 11.1% (4/36) and 14.7% (9/61) of the total births at 22, 23 and 24 weeks’ gestation (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). Of all intrapartum deaths, 78.2% (18/23) occurred in women that were already hospitalised (minimum of 9h and maximum of 15 days).<elsevierMultimedia ident="fig0005"></elsevierMultimedia>Resuscitation efforts were made at birth in 11 of the 23 patients that died during delivery (in five, advanced resuscitation was performed with chest compressions with or without epinephrine administration).Risk factors associated with intrapartum foetal death (<a class="elsevierStyleCrossRefs" href="#tbl0015">Tables 3 and 4</a>)<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a> shows the perinatal factors under study, comparing the preterm live birth group with the intrapartum death group. We found statistically significant differences in the use of assisted reproductive technology (20.8% vs 41.6%; P=0.01), abnormal foetal ultrasound findings (32.7% vs 65.2%; P=0.001;with a greater percentage of abnormal Doppler findings and oligohydramnios in the preterm intrapartum death group), administration of antenatal corticosteroids (91.1% vs 34.7%; P<0.001), indication of caesarean delivery (62.7% vs 30.4%; P=0.002), gestational age (weeks’ gestation, 28+5 vs 24+4; P<0.001), birth weight (1100g vs 650g; P<0.001) and small for gestational age (8.8% vs 26%; P=0.005) (<a class="elsevierStyleCrossRefs" href="#tbl0015">Tables 3 and 4</a>).<elsevierMultimedia ident="tbl0015"></elsevierMultimedia><elsevierMultimedia ident="tbl0020"></elsevierMultimedia>The multivariate analysis showed that the use of assisted reproductive technology (OR, 2.6; 95% CI, 1.02–7.55), abnormal foetal ultrasound findings (OR, 4.8; 95% CI, 1.6–15.1), lack of administration of antenatal corticosteroids (OR, 8.27; 95% CI, 2.52–27.15), low gestational age (22–25 weeks’ gestation; OR, 5.37; 95% CI, 1.21–23.7) and low birth weight (OR, 3.67; 95% CI, 1.05–12.9) were independent risk factors associated with intrapartum foetal death.DiscussionTo our knowledge, this is the first study that analyses the risk factors specifically associated with intrapartum foetal death in gestations of less than 32 weeks.Foetal mortality is a key indicator in perinatal care, and it remains high even today.<a class="elsevierStyleCrossRef" href="#bib0300">21</a> In our hospital, the cumulative foetal mortality rate in gestations of less than 32 weeks during the period under study was of 2.3‰. Out of all cases of foetal death, 63.1% took place between 22 and 31+6 weeks’ gestation, with a mortality rate of 11.3% and a rate of intrapartum foetal death of 2.6%. These percentages are similar to others reported in the literature, although there is significant variability in the reported rates, as evinced by the MOSAIC study (foetal mortality ranging between 12.8% and 22.3% and intrapartum mortality between 1.2% and 4.8%).<a class="elsevierStyleCrossRef" href="#bib0220">5</a> But large-scale national studies on the survival of preterm newborns do not always analyse this particular rate.<a class="elsevierStyleCrossRefs" href="#bib0305">22,23</a> In Spain, a study published recently analysed the mortality of preterm newborns of 23 to 26 weeks of gestational age,<a class="elsevierStyleCrossRef" href="#bib0315">24</a> but did not include foetal mortality. However, foetal mortality reaches the highest percentages precisely in this group of the most premature,<a class="elsevierStyleCrossRefs" href="#bib0220">5,15,25</a> which in our review was as high as 16.2%.Various factors may hinder the analysis of foetal mortality, including the variability in the gestational age starting from which cases are reported to registers<a class="elsevierStyleCrossRefs" href="#bib0240">9,26</a> or the occasional difficulty of differentiating between antepartum and intrapartum foetal death.<a class="elsevierStyleCrossRef" href="#bib0330">27</a> Although intrapartum foetal mortality has decreased in recent years, it still represents a significant percentage of the total births,<a class="elsevierStyleCrossRefs" href="#bib0220">5,25,28</a> and amounted to 2.6% of the total in our study, with a significantly increased percentage in preterm births before 25 weeks’ gestation (15.2%). Another salient finding of our analysis was that 78.2% of intrapartum deaths (18/23) occurred in mothers that were already hospitalised, and the relevance of this finding may be twofold. First, these cases can be monitored more closely before and during labour; and second, parents may be given information before delivery that would usually include a prediction of survival, which should be estimated as soon as there is a risk of preterm birth, and not only when the baby is born alive. For all the above reasons, intrapartum foetal mortality and the associated risk factors are of considerable clinical and epidemiological relevance.Numerous authors have analysed maternal and obstetric risk factors associated with foetal mortality.<a class="elsevierStyleCrossRefs" href="#bib0230">7,29,30</a> Some studies have found differences in the risk factors associated with foetal mortality in term versus preterm deliveries.<a class="elsevierStyleCrossRefs" href="#bib0245">10,31</a> This is also the case with antepartum versus intrapartum foetal mortality, for while they may have similar causes, intrapartum foetal mortality is closely associated with obstetric practices and intrauterine hypoxia.<a class="elsevierStyleCrossRefs" href="#bib0255">12,17,28</a> However, we did not find any studies that specifically analysed the potential perinatal risk factors associated with intrapartum foetal death in preterm deliveries.Some of the risk factors associated to intrapartum foetal mortality are advanced maternal age, multiple pregnancy, lack of prenatal care, premature rupture of membranes or chronic diseases such as obesity.<a class="elsevierStyleCrossRefs" href="#bib0255">12–14</a> Other risk factors associated with foetal mortality in preterm deliveries are placental abruption, preeclampsia or intrauterine infection.<a class="elsevierStyleCrossRefs" href="#bib0230">7,10,11</a> In our study, we did not find a significant difference in these risk factors, and while we found a greater percentage of obstetric haemorrhage, chronic maternal disease and chorioamnionitis, these differences were not statistically significant. We did find statistically significant associations with TRA, abnormal foetal ultrasound findings (abnormal Doppler and oligohydramnios), lower percentage of caesarean deliveries, lower administration of antenatal corticosteroids, lower gestational age and low birth weight. Although performance of caesarean delivery has been associated with a decreased foetal mortality rate,<a class="elsevierStyleCrossRefs" href="#bib0225">6,32</a> our multivariate analysis did not find it to be an independent risk factor for intrapartum foetal death. Lower gestational age,<a class="elsevierStyleCrossRefs" href="#bib0270">15,21</a> small for gestational age birth<a class="elsevierStyleCrossRef" href="#bib0255">12</a> and abnormal foetal ultrasound findings are well-known and thoroughly studied risk factors. An abnormal foetal Doppler ultrasound is a predictor of foetal compromise and perinatal mortality, especially in high-risk pregnancies such as those with placental insufficiency or IUGR.<a class="elsevierStyleCrossRefs" href="#bib0345">30,31,33,34</a> Both oligohydramnios or polyhydramnios are abnormal and potentially place the foetus at risk, but their impact on foetal mortality remains unclear.<a class="elsevierStyleCrossRef" href="#bib0360">33</a> However, a recent systematic review suggests that oligohydramnios is associated with increased perinatal mortality.<a class="elsevierStyleCrossRef" href="#bib0370">35</a>Assisted reproductive technologies are usually associated with advanced maternal age, maternal chronic disease or multiple pregnancy, all of them factors that increase the risk of foetal death. A recent study found that singleton pregnancies achieved through ART carried a higher risk of foetal mortality at 22–27 weeks’ gestation.<a class="elsevierStyleCrossRef" href="#bib0375">36</a> However, we did not find any studies that specifically assessed the association between ART and intrapartum mortality. A lack of antenatal corticosteroid treatment in preterm newborns is associated with an increased postnatal mortality and worse short-term and long-term outcomes.<a class="elsevierStyleCrossRefs" href="#bib0380">37,38</a> But we also found no studies analysing the effect of antenatal corticosteroids on intrapartum foetal mortality, despite the clear association of a lack of exposure with increased foetal mortality. We believe that this is an important aspect, as of all the factors that we identified, this is the only one that can be modified.One of the limitations of this study is that we did not analyse the risk factors for antenatal foetal death, which may require specific study in this group of patients. Another limitation is that this was a retrospective hospital-based single-centre study conducted in a facility that manages a high percentage of high-risk pregnancies where the number of foetuses that die during delivery is small. Thus, it would be interesting to conduct broader studies to clarify whether these risk factors have a direct effect on intrapartum mortality or rather reflect a less invasive approach in more premature foetuses with poorer prognoses, as clinical decisions influenced by foetal prognosis may have the most significant impact on the survival of these patients.<a class="elsevierStyleCrossRef" href="#bib0390">39</a>ConclusionIntrapartum foetal death occurs in a significant number of preterm births. Its study is of great clinical relevance, first, because estimations of survival for preterm newborns should start being made from the moment that there is risk of preterm birth; and secondly, because analysing the factors potentially associated with it may help optimise perinatal care and thus increase the survival of babies born preterm.Conflict of interestsThe authors have no conflict of interests to declare." "textoCompletoSecciones" => array:1 [ "secciones" => array:12 [ 0 => array:3 [ "identificador" => "xres805119" "titulo" => "Abstract" "secciones" => array:5 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Introduction" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Objective" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Material and methods" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Results" ] 4 => array:2 [ "identificador" => "abst0025" "titulo" => "Conclusion" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec803276" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres805118" "titulo" => "Resumen" "secciones" => array:5 [ 0 => array:2 [ "identificador" => "abst0030" "titulo" => "Introducción" ] 1 => array:2 [ "identificador" => "abst0035" "titulo" => "Objetivo" ] 2 => array:2 [ "identificador" => "abst0040" "titulo" => "Material y métodos" ] 3 => array:2 [ "identificador" => "abst0045" "titulo" => "Resultados" ] 4 => array:2 [ "identificador" => "abst0050" "titulo" => "Conclusión" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec803275" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:3 [ "identificador" => "sec0010" "titulo" => "Population and methods" "secciones" => array:1 [ 0 => array:2 [ "identificador" => "sec0015" "titulo" => "Population" ] ] ] 6 => array:3 [ "identificador" => "sec0020" "titulo" => "Methods" "secciones" => array:1 [ 0 => array:2 [ "identificador" => "sec0025" "titulo" => "Statistical analysis" ] ] ] 7 => array:3 [ "identificador" => "sec0030" "titulo" => "Results" "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0035" "titulo" => "Foetal mortality (Tables 1 and 2)" ] 1 => array:2 [ "identificador" => "sec0040" "titulo" => "Risk factors associated with intrapartum foetal death (Tables 3 and 4)" ] ] ] 8 => array:2 [ "identificador" => "sec0045" "titulo" => "Discussion" ] 9 => array:2 [ "identificador" => "sec0050" "titulo" => "Conclusion" ] 10 => array:2 [ "identificador" => "sec0055" "titulo" => "Conflict of interests" ] 11 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2015-10-28" "fechaAceptado" => "2016-04-22" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec803276" "palabras" => array:3 [ 0 => "Extreme prematurity" 1 => "Foetal mortality" 2 => "Risk factors" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec803275" "palabras" => array:3 [ 0 => "Prematuridad" 1 => "Mortalidad fetal" 2 => "Factores de riesgo" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "IntroductionPre-term delivery is one of the leading causes of foetal and perinatal mortality. However, perinatal risk factors associated with intra-partum foetal death in preterm deliveries have not been well studied. ObjectiveTo analyse foetal mortality and perinatal risk factors associated with intra-partum foetal mortality in pregnancies of less than 32 weeks gestational age. Material and methodsThe study included all preterm deliveries between 22 and 31 +1 weeks gestational age (WGA), born in a tertiary-referral hospital, over a period of 7 years (2008–2014). A logistic regression model was used to identify perinatal risk factors associated with intra-partum foetal mortality (foetal malformations and chromosomal abnormalities were excluded). ResultsDuring the study period, the overall foetal mortality was 63.1% (106/168) (≥22 weeks of gestation) and occurred in pregnancies of less than 32 WGA. A total of 882 deliveries between 22 and 31+6 weeks of gestation were included for analysis. The rate of foetal mortality was 11.3% (100/882). The rate of intra-partum foetal death was 2.6% (23/882), with 78.2% (18/23) of these cases occurring in hospitalised pregnancies. It was found that Assisted Reproductive Techniques, abnormal foetal ultrasound, no administration of antenatal steroids, lower gestational age, and small for gestational age, were independent risk factors associated with intra-partum foetal mortality. ConclusionThis study showed that there is a significant percentage intra-partum foetal mortality in infants between 22 and 31+6 WGA. The analysis of intrapartum mortality and risk factors associated with this mortality is of clinical and epidemiological interest to optimise perinatal care and improve survival of preterm infants." "secciones" => array:5 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Introduction" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Objective" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Material and methods" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Results" ] 4 => array:2 [ "identificador" => "abst0025" "titulo" => "Conclusion" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "IntroducciónEl parto prematuro es una de las principales causas de mortalidad perinatal y fetal. Sin embargo, los factores de riesgo perinatales asociados a mortalidad fetal intraparto en partos pretérmino no han sido bien analizados. ObjetivoAnalizar la mortalidad fetal y los factores de riesgo perinatales asociados a mortalidad fetal intraparto en gestaciones de menos de 32 semanas. Material y métodosSe incluyeron en el análisis todos los partos pretérmino entre las semanas 22 y 31+6 días, nacidos en un hospital terciario durante un periodo de 7 años (2008-2014). Se realizó un análisis de regresión logística para identificar factores de riesgo perinatales asociados a mortalidad fetal intraparto (excluidos malformaciones y cromosomopatías severas). ResultadosEn este período el 63,1% (106/168) de la mortalidad fetal (≥22 semanas) se produjo en gestaciones menores de 32 semanas. Ochocientos ochenta y dos nacimientos entre las semanas 22 y 31+6 días fueron incluidos en el análisis. La mortalidad fetal fue del 11,3% (100/882). La mortalidad fetal intraparto fue del 2,6% (23/882), afectando en el 78,2% de los casos (18/23) a gestantes hospitalizadas. Encontramos que las técnicas de reproducción asistida, la ecografía fetal patológica, la no administración de corticoides antenatales, la menor edad gestacional y el bajo peso para la edad gestacional fueron factores de riesgo independientes asociados a mortalidad fetal intraparto. ConclusiónLa mortalidad fetal intraparto afectó a un porcentaje importante de nacimientos entre las semanas 22 y 31+6 días. El análisis de la mortalidad fetal intraparto y los factores de riesgo asociados a esta resulta de gran interés clínico y epidemiológico para optimizar el cuidado perinatal y aumentar la supervivencia del recién nacido pretérmino." "secciones" => array:5 [ 0 => array:2 [ "identificador" => "abst0030" "titulo" => "Introducción" ] 1 => array:2 [ "identificador" => "abst0035" "titulo" => "Objetivo" ] 2 => array:2 [ "identificador" => "abst0040" "titulo" => "Material y métodos" ] 3 => array:2 [ "identificador" => "abst0045" "titulo" => "Resultados" ] 4 => array:2 [ "identificador" => "abst0050" "titulo" => "Conclusión" ] ] ] ] "NotaPie" => array:2 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "Previous presentation: This study was presented as Risk factors associated with intrapartum stillbirths in preterm babies at the 4th International Congress of UENPS; December 11–14; Athens, Greece." ] 1 => array:2 [ "etiqueta" => "☆☆" "nota" => "Please cite this article as: Zeballos Sarrato S, Villar Castro S, Ramos Navarro C, Zeballos Sarrato G, Sánchez Luna M. Factores de riesgo asociados a mortalidad fetal intraparto en recién nacidos pretérmino. An Pediatr (Barc). 2017;86:127–134." ] ] "multimedia" => array:5 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1154 "Ancho" => 1655 "Tamanyo" => 71131 ] ] "descripcion" => array:1 [ "en" => "Antepartum and intrapartum foetal death by gestational age. Y axis: percentage of stillbirths (antepartum and intrapartum death) over the total number of births. X axis: gestational age in weeks." ] ] 1 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:3 [ "leyenda" => "n, total number of cases per year; (%): percentage of foetal deaths in gestations of 22 or fewer weeks." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Year \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">2008 \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">2009 \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">2010 \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">2011 \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">2012 \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">2013 \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">2014 \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Total \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Total births, n \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">8177 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">6375 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">7707 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">6245 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">5479 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">5416 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">5365 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">44,764 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Foetal deaths at ≥22 weeks, n \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">29 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">30 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">22 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">24 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">22 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">22 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">19 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">168 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Foetal deaths at 22–31+6 weeks, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">24 (82.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">20 (66.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">15 (68.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">17 (70.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">14 (63.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">7 (35.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">9 (47.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">106 (63.1) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Foetal mortality rate<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> at ≥22weeks \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3.5‰ \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">4.7‰ \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2.8‰ \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3.8‰ \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">4‰ \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3.1‰ \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3.5‰ \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3.7‰ \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Foetal mortality rate at 22–31+6 weeks \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2.9‰ \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3.1‰ \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1.9‰ \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2.7‰ \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2.5‰ \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1.1‰ \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1.6‰ \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2.3‰ \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1351133.png" ] ] ] "notaPie" => array:1 [ 0 => array:3 [ "identificador" => "tblfn0005" "etiqueta" => "a" "nota" => "Foetal mortality rates based on WHO recommended definitions (per 1000 births)." ] ] ] "descripcion" => array:1 [ "en" => "Foetal mortality in births at 22 or fewer weeks’ gestation and between 22 and 31+6 weeks’ gestation (without taking into account the exclusion criteria)." ] ] 2 => array:8 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at2" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:3 [ "leyenda" => "CI, confidence interval; n, total number of cases per year; w, weeks; (%): percentage of foetal deaths and 95% confidence interval by gestational age." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Gestational age (weeks) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">22 w n (%) (95% CI) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">23 w n (%) (95% CI)  \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">24 w n (%) (95% CI) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">25 w n (%) (95% CI) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">26 w n (%) (95% CI) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">27 w n (%) (95% CI) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">28 w n (%) (95% CI) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">29 w n (%) (95% CI) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">30 w n (%) (95% CI) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">31 w n (%) (95% CI) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Total n (%) (95% CI) \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Total births \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">36 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">61 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">88 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">74 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">98 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">117 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">107 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">130 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">163 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">882 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Foetal deaths \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">5 (62.5) (24.5–91.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">10 (27.7) (11.8–43.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">12 (19.6) (8.9–30.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">11 (12.5) (5–20) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">9 (12.1) (4–20.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">12 (12.2) (5.2–19.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">13 (11.1) (5–17.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">7 (6.5) (1.4–11.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">8 (6.1) (1.6–10.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">13 (8) (3.5–12.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">100 (11.3) (9.2–13.8) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Antepartum foetal deaths \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2 (25) (3.2–65.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">6 (16.6) (3.1–30.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3 (4.9) (1–13.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">9 (10.2) (3.3–17.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">9 (12.1) (4–20.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">10 (10.2) (3.7–16.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">13 (11.1) (5–17.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">6 (5.6) (0.8–10.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">7 (5.4) (1.1–9.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">12 (7.4) (3–11.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">77 (8.7) (6.8–10.6)  \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Intrapartum foetal deaths  \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3 (37.5) (8.5–75.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">4 (11.1) (3.1–26.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">9 (14.7) (5–24.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2 (2.2) (0.3–8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0 (0) (0–4.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2 (2) (0.2–7.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0 (0) (0–3.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1 (0.9) (0.1–5.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1 (0.7) (0.02–4.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1 (0.6) (0.02–3.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">23 (2.6) (1.5–3.7) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Hospitalised mothers<a class="elsevierStyleCrossRef" href="#tblfn0010">a</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">18 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Live births \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3 (37.5) (8.5–75.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">26 (72.2) (56.2–88.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">49 (80.3) (69.5–91) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">77 (87.5) (80.5–95) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">65 (87.8) (79.7–96) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">86 (87.7) (80.7–94.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">104 (88.8) (82.8–95) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">100 (93.4) (88.3–98.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">122 (93.9) (89.3–98.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">150 (92) (87.6–96.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">782 (88.7) (86.5–90.8) \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1351132.png" ] ] ] "notaPie" => array:1 [ 0 => array:3 [ "identificador" => "tblfn0010" "etiqueta" => "a" "nota" => "The calculation of intrapartum foetal deaths included foetuses from mothers that were hospitalised in our centre." ] ] ] "descripcion" => array:1 [ "en" => "Foetal mortality (antepartum and intrapartum) and live births by gestational age." ] ] 3 => array:8 [ "identificador" => "tbl0015" "etiqueta" => "Table 3" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at3" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:3 [ "leyenda" => "IUGR, intrauterine growth restriction; n, total number of patients in each group; ROM, rupture of membranes; (%), percentage of the total of live births or intrapartum foetal deaths, by column." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Prenatal variables under study \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Live births \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Intrapartum foetal deaths \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">P \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Total births, n \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">782 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">23 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Maternal age in years, mean±SD<a class="elsevierStyleCrossRef" href="#tblfn0015">a</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">32.1±6.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">33.5±5.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.24 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Prenatal care, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">749 (95.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">23 (100) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.092 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Maternal disease during gestation<a class="elsevierStyleCrossRef" href="#tblfn0025">c</a>, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">317 (41) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">12 (52.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.30 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Preeclampsia \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">113 (14.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">4 (17.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.70 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Gestational diabetes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">59 (7.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1 (4.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.55 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Obstetric haemorrhage \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">69 (9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">4 (17.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.06 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Unfavourable obstetric history \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">97 (12.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3 (13) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.94 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Chronic disease \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">78 (10.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">5 (21.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.07 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Assisted reproductive technology (ART), n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">163 (20.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">10 (41.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.01<a class="elsevierStyleCrossRef" href="#tblfn0035">*</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Multiple pregnancy, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">296 (37.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">11 (47.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.33 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Abnormal foetal ultrasound<a class="elsevierStyleCrossRef" href="#tblfn0025">c</a>, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">254 (32.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">15 (65.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.001<a class="elsevierStyleCrossRef" href="#tblfn0035">*</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">IUGR with normal Doppler \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">39 (5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2 (8.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.75 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">IUGR with abnormal Doppler<a class="elsevierStyleCrossRef" href="#tblfn0030">d</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">77 (9.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">4 (17.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.4 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Abnormal Doppler <a class="elsevierStyleCrossRef" href="#tblfn0030">d</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">25 (3.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">4 (17.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.04<a class="elsevierStyleCrossRef" href="#tblfn0035">*</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Oligohydramnios \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">140 (18.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">10 (43.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.002<a class="elsevierStyleCrossRef" href="#tblfn0035">*</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Polyhydramnios \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">10 (1.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1 (4.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.60 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Caesarean delivery, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">491 (62.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">7 (30.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.002<a class="elsevierStyleCrossRef" href="#tblfn0035">*</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">ROM latency>1h, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">285 (36.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">11 (47.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.26 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">ROM latency, median (Q1–Q3)<a class="elsevierStyleCrossRef" href="#tblfn0020">b</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">72 (13–220) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">144 (12–270) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.47 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Maternal antibiotherapy, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">464 (59.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">15 (65.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.57 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Suspectedchorioamnionitis, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">192 (24.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">9 (39.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.11 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Antenatal corticosteroids (at least one dose), n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">713 (91.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">8 (34.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><0.001<a class="elsevierStyleCrossRef" href="#tblfn0035">*</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Full course \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">393 (50.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">5 (21.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.011<a class="elsevierStyleCrossRef" href="#tblfn0035">*</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Partial course (one dose) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">160 (20.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1 (4.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.10 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Corticosteroids>7 days \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">160 (20.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2 (8.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.21 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">No dose \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">69 (8.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">15 (65.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><0.001<a class="elsevierStyleCrossRef" href="#tblfn0035">*</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Gestational age (weeks+days), median (Q1–Q3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">28+5 (26+3; 30+3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">24+4 (24; 27) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><0.001<a class="elsevierStyleCrossRef" href="#tblfn0035">*</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Birth weight (g), mean±SD \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1100±379g \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">650±210g \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><0.001<a class="elsevierStyleCrossRef" href="#tblfn0035">*</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Small for gestational age, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">69 (8.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">6 (26) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.005<a class="elsevierStyleCrossRef" href="#tblfn0035">*</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Male sex, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">416 (53.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">13 (56.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.75 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1351130.png" ] ] ] "notaPie" => array:5 [ 0 => array:3 [ "identificador" => "tblfn0015" "etiqueta" => "a" "nota" => "Mean±standard deviation." ] 1 => array:3 [ "identificador" => "tblfn0020" "etiqueta" => "b" "nota" => "Median (first and third quartiles)." ] 2 => array:3 [ "identificador" => "tblfn0025" "etiqueta" => "c" "nota" => "Cases in which the value of the analysed factor was unknown in the column of live births. Percentage based on the denominator adjusted for these missing data: maternal disease during pregnancy (10 cases), gestational diabetes (16 cases), preeclampsia (10 cases), and abnormal foetal ultrasound (6 cases)." ] 3 => array:3 [ "identificador" => "tblfn0030" "etiqueta" => "d" "nota" => "We conducted the statistical analysis by grouping all patients with abnormal Doppler in each column (abnormal Doppler and IUGR with abnormal Doppler): P=0.3*." ] 4 => array:3 [ "identificador" => "tblfn0035" "etiqueta" => "*" "nota" => "Statistically significant." ] ] ] "descripcion" => array:1 [ "en" => "Comparison of the perinatal risk factors under study between live births and intrapartum foetal deaths at fewer than 32 weeks’ gestation." ] ] 4 => array:8 [ "identificador" => "tbl0020" "etiqueta" => "Table 4" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at4" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Perinatal risk factors \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">P \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">OR \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">95% CI \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Assisted reproductive technologies \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.048<a class="elsevierStyleCrossRef" href="#tblfn0045">*</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">(1.02–7.55) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Abnormal foetal echocardiogram \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.005<a class="elsevierStyleCrossRef" href="#tblfn0045">*</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">(1.6–15.1) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">No antenatal corticosteroids \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><0.001<a class="elsevierStyleCrossRef" href="#tblfn0045">*</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">8.27 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">(2.52–27.15) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Caesarean delivery \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.55 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">(0.21–2.3) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">22–25 weeks’ gestation<a class="elsevierStyleCrossRef" href="#tblfn0040">a</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.026<a class="elsevierStyleCrossRef" href="#tblfn0045">*</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5.37 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">(1.21–23.7) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">26–28 weeks’ gestation<a class="elsevierStyleCrossRef" href="#tblfn0040">a</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.98 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.98 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">(0.16–6.11) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Small for gestational age \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.042<a class="elsevierStyleCrossRef" href="#tblfn0045">*</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3.67 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">(1.05–12.9) \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1351131.png" ] ] ] "notaPie" => array:2 [ 0 => array:3 [ "identificador" => "tblfn0040" "etiqueta" => "a" "nota" => "Comparison with reference group (delivered at 29–31 weeks’ gestation)." ] 1 => array:3 [ "identificador" => "tblfn0045" "etiqueta" => "*" "nota" => "Statistically significant." ] ] ] "descripcion" => array:1 [ "en" => "Independent risk factors associated with intrapartum foetal death between 22 and 31+6 weeks’ gestation (multivariate analysis)." ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:39 [ 0 => array:3 [ "identificador" => "bib0200" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Fetal death" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "R.M. 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Risks factors associated with intra-partum foetal mortality in pre-term infants

Factores de riesgo asociados a mortalidad fetal intraparto en recién nacidos pretérmino

Susana Zeballos Sarrato

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szeballitos@hotmail.com

Corresponding author.

, Sonia Villar Castro, Cristina Ramos Navarro, Gonzalo Zeballos Sarrato, Manuel Sánchez Luna

Servicio de Neonatología, Hospital General Universitario Gregorio Marañón, Madrid, Spain

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especially inpregnancies at the limit of viability&#46;<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">6</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">The foetal mortality rate in developed countries is estimated at five to six per 1000 births&#44;<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">7</span></a> and based on data from large-scale registers worldwide&#44; the antepartum foetal mortality rate in the developed world is 5&#46;2 per 1000 births and the intrapartum foetal mortality rate is 0&#46;9 per 1000 births&#46; In recent years there has been a decrease in intrapartum mortality&#44; which may be due to more intensive antenatal care&#44; improved monitoring during labour and an increased caesarean delivery rate&#46;<a class="elsevierStyleCrossRefs" href="#bib0215"><span class="elsevierStyleSup">4&#44;8</span></a> Numerous studies have analysed potential causes of foetal death in developed countries&#46;<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">9</span></a> Foetal death seems to be a multifactorial phenomenon that is sometimes difficult to explain and with multiple aetiologies&#46;<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">7</span></a> Several studies demonstrate that the risk factors associated with foetal death vary by gestational age and the timing of death&#44; that is&#44; whether it occurred before or during delivery&#46;<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">7&#44;10&#8211;15</span></a> Since in developed countries intrapartum foetal death in preterm deliveries usually takes place in hospital settings&#44; the detection of potential risk factors associated with it is of particular clinical relevance&#46; However&#44; we did not find any studies that specifically addressed perinatal factors that could potentially increase the risk of intrapartum foetal death in preterm births&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">The aim of this study was to analyse foetal mortality between 22 and 31<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>6 weeks&#8217; gestation and to identify potential perinatal risk factors associated with intrapartum foetal death&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Population and methods</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Population</span><p id="par0020" class="elsevierStylePara elsevierViewall">We conducted a study of pregnant women that gave birth preterm between 22 and 31<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>6 weeks&#8217; gestation at the Hospital General Universitario Gregorio Mara&#241;&#243;n de Madrid &#40;level IIIc referral hospital for high-risk pregnancies and congenital neonatal diseases&#41;&#46;</p></span></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Methods</span><p id="par0025" class="elsevierStylePara elsevierViewall">We conducted a retrospective observational study over a period of seven years &#40;January 2008 to December 2014&#41;&#46; We collected the data recorded in the SEN 1&#46;500 morbidity and mortality register prospectively&#46; We collected data for the factors under study that are not recorded in this register prospectively between 2012 and 2014 and retrospectively for the 2008&#8211;2011 period&#46; The study was approved by the Ethics and Clinical Research Committee of the Hospital General Universitario Gregorio Mara&#241;&#243;n&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">We applied the definitions of foetal death proposed by the WHO<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">16</span></a>&#58; 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including preeclampsia&#44; gestational diabetes&#44; antepartum haemorrhage&#44; unfavourable obstetric history &#40;&#62;2 previous miscarriages or cervical incompetence requiring cervical cerclage in the current pregnancy&#41; and chronic disease &#40;hypertension&#44; diabetes mellitus type<span class="elsevierStyleSmallCaps">1</span>&#44; obesity&#44; substance use&#44; renal&#44; hepatic&#44; cardiovascular or autoimmune disease&#44; or cancer&#41;&#59; assisted reproductive technology &#40;ART&#41;&#59; multiple pregnancy&#59; abnormal foetal ultrasound &#40;intrauterine growth restriction &#91;IUGR&#93;&#44; abnormal Doppler&#44; oligohydramniosorpolyhydramnios&#41;<a class="elsevierStyleCrossRefs" href="#bib0280"><span class="elsevierStyleSup">17&#44;18</span></a>&#59; premature rupture of membranes and latency period in hours&#59; antenatal administration of antibiotics&#59; suspicion of chorioamnionitis<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">19</span></a>&#59; antenatal administration of corticosteroids &#40;number of doses and timing of administration relative to delivery&#41;&#59; mode of delivery &#40;vaginal or caesarean&#41;&#59; gestational age &#40;calculated on the basis of foetal ultrasound in the first trimester and date of last menstrual period&#44; and in cases with no prenatal care&#44; based on the physical examination of the newborn&#41;&#59; birth weight&#44; small for gestational age &#40;birth weight<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>10th percentile&#41;<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">20</span></a> and sex&#46;</p><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Statistical analysis</span><p id="par0050" class="elsevierStylePara elsevierViewall">We present the results of continuous variables as mean and standard deviation&#44; and categorical variables as absolute frequencies and percentages&#46; We have expressed quantitative variables that did not follow a normal distribution as median and interquartile range &#40;25th&#8211;75th percentile&#41;&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">To compare the means of two groups&#44; we used a parametric test &#40;Student&#39;s <span class="elsevierStyleItalic">t</span> test&#41; or nonparametric test &#40;Mann&#8211;Whitney <span class="elsevierStyleItalic">U</span> test&#41; as appropriate&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">We studied the association of mortality with qualitative variables by means of the chi square test or Fisher&#39;s exact test&#44; and the association between quantitative variables by means of Pearson&#39;s correlation coefficient or Spearman&#39;s rho&#46; We conducted a multivariate logistic regression analysis to identify potential factors associated with intrapartum death with a 95&#37; confidence interval &#40;CI&#41;&#46; The statistical analysis was performed using SPSS<span class="elsevierStyleSup">&#174;</span> version 21&#46;0 and EPIDAT 3&#46;1&#46; Results with a <span class="elsevierStyleItalic">p</span>-value of less than 0&#46;05 were considered statistically significant&#46;</p></span></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Results</span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Foetal mortality &#40;<a class="elsevierStyleCrossRefs" href="#tbl0005">Tables 1 and 2</a>&#41;</span><p id="par0065" class="elsevierStylePara elsevierViewall">The mean foetal mortality rate at 22 to 31<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>6 weeks&#8217; gestation was 2&#46;3&#8240; &#40;1&#46;1&#8211;3&#46;1&#8240;&#41;&#46; During this period&#44; 63&#46;1&#37; &#40;106&#47;168&#41; of foetal deaths took place in gestations of less than 32 weeks&#46; &#40;<a class="elsevierStyleCrossRefs" href="#tbl0005">Tables 1 and 2</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0070" class="elsevierStylePara elsevierViewall">In gestations of 22 to 31<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>6 weeks&#44; the cumulative incidence of foetal mortality &#40;excluding six foetuses with malformations and&#47;or chromosomal disorders&#41; was 11&#46;3&#37; &#40;100&#47;882&#59; 95&#37;CI&#44; 9&#46;2&#8211;13&#46;8&#41;&#44; with considerable variation based on gestational age &#40;62&#46;5&#37; at 22 weeks&#8217; gestation&#44; compared to &#60;10&#37; at 29 or more weeks&#8217; gestation&#41;&#46; Intrapartum foetal death amounted to 2&#46;6&#37; of the total births &#40;23&#47;882&#59; 95&#37; CI&#44; 1&#46;5&#8211;3&#46;7&#41; and 23&#37; of foetal deaths &#40;23&#47;100&#41;&#46; Intrapartum foetal mortality was higher in gestations of less than 25 weeks&#44; and reached 37&#46;5&#37; &#40;3&#47;8&#41;&#44; 11&#46;1&#37; &#40;4&#47;36&#41; and 14&#46;7&#37; &#40;9&#47;61&#41; of the total births at 22&#44; 23 and 24 weeks&#8217; gestation &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; Of all intrapartum deaths&#44; 78&#46;2&#37; &#40;18&#47;23&#41; occurred in women that were already hospitalised &#40;minimum of 9<span class="elsevierStyleHsp" style=""></span>h and maximum of 15 days&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0075" class="elsevierStylePara elsevierViewall">Resuscitation efforts were made at birth in 11 of the 23 patients that died during delivery &#40;in five&#44; advanced resuscitation was performed with chest compressions with or without epinephrine administration&#41;&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Risk factors associated with intrapartum foetal death &#40;<a class="elsevierStyleCrossRefs" href="#tbl0015">Tables 3 and 4</a>&#41;</span><p id="par0080" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a> shows the perinatal factors under study&#44; comparing the preterm live birth group with the intrapartum death group&#46; We found statistically significant differences in the use of assisted reproductive technology &#40;20&#46;8&#37; vs 41&#46;6&#37;&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;01&#41;&#44; abnormal foetal ultrasound findings &#40;32&#46;7&#37; vs 65&#46;2&#37;&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#59;with a greater percentage of abnormal Doppler findings and oligohydramnios in the preterm intrapartum death group&#41;&#44; administration of antenatal corticosteroids &#40;91&#46;1&#37; vs 34&#46;7&#37;&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#44; indication of caesarean delivery &#40;62&#46;7&#37; vs 30&#46;4&#37;&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;002&#41;&#44; gestational age &#40;weeks&#8217; gestation&#44; 28<span class="elsevierStyleSup">&#43;5</span> vs 24<span class="elsevierStyleSup">&#43;4</span>&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#44; birth weight &#40;1100<span class="elsevierStyleHsp" style=""></span>g vs 650<span class="elsevierStyleHsp" style=""></span>g&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41; and small for gestational age &#40;8&#46;8&#37; vs 26&#37;&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;005&#41; &#40;<a class="elsevierStyleCrossRefs" href="#tbl0015">Tables 3 and 4</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><elsevierMultimedia ident="tbl0020"></elsevierMultimedia><p id="par0085" class="elsevierStylePara elsevierViewall">The multivariate analysis showed that the use of assisted reproductive technology &#40;OR&#44; 2&#46;6&#59; 95&#37; CI&#44; 1&#46;02&#8211;7&#46;55&#41;&#44; abnormal foetal ultrasound findings &#40;OR&#44; 4&#46;8&#59; 95&#37; CI&#44; 1&#46;6&#8211;15&#46;1&#41;&#44; lack of administration of antenatal corticosteroids &#40;OR&#44; 8&#46;27&#59; 95&#37; CI&#44; 2&#46;52&#8211;27&#46;15&#41;&#44; low gestational age &#40;22&#8211;25 weeks&#8217; gestation&#59; OR&#44; 5&#46;37&#59; 95&#37; CI&#44; 1&#46;21&#8211;23&#46;7&#41; and low birth weight &#40;OR&#44; 3&#46;67&#59; 95&#37; CI&#44; 1&#46;05&#8211;12&#46;9&#41; were independent risk factors associated with intrapartum foetal death&#46;</p></span></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Discussion</span><p id="par0090" class="elsevierStylePara elsevierViewall">To our knowledge&#44; this is the first study that analyses the risk factors specifically associated with intrapartum foetal death in gestations of less than 32 weeks&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">Foetal mortality is a key indicator in perinatal care&#44; and it remains high even today&#46;<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">21</span></a> In our hospital&#44; the cumulative foetal mortality rate in gestations of less than 32 weeks during the period under study was of 2&#46;3&#8240;&#46; Out of all cases of foetal death&#44; 63&#46;1&#37; took place between 22 and 31<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>6 weeks&#8217; gestation&#44; with a mortality rate of 11&#46;3&#37; and a rate of intrapartum foetal death of 2&#46;6&#37;&#46; These percentages are similar to others reported in the literature&#44; although there is significant variability in the reported rates&#44; as evinced by the MOSAIC study &#40;foetal mortality ranging between 12&#46;8&#37; and 22&#46;3&#37; and intrapartum mortality between 1&#46;2&#37; and 4&#46;8&#37;&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">5</span></a> But large-scale national studies on the survival of preterm newborns do not always analyse this particular rate&#46;<a class="elsevierStyleCrossRefs" href="#bib0305"><span class="elsevierStyleSup">22&#44;23</span></a> In Spain&#44; a study published recently analysed the mortality of preterm newborns of 23 to 26 weeks of gestational age&#44;<a class="elsevierStyleCrossRef" href="#bib0315"><span class="elsevierStyleSup">24</span></a> but did not include foetal mortality&#46; However&#44; foetal mortality reaches the highest percentages precisely in this group of the most premature&#44;<a class="elsevierStyleCrossRefs" href="#bib0220"><span class="elsevierStyleSup">5&#44;15&#44;25</span></a> which in our review was as high as 16&#46;2&#37;&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">Various factors may hinder the analysis of foetal mortality&#44; including the variability in the gestational age starting from which cases are reported to registers<a class="elsevierStyleCrossRefs" href="#bib0240"><span class="elsevierStyleSup">9&#44;26</span></a> or the occasional difficulty of differentiating between antepartum and intrapartum foetal death&#46;<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">27</span></a> Although intrapartum foetal mortality has decreased in recent years&#44; it still represents a significant percentage of the total births&#44;<a class="elsevierStyleCrossRefs" href="#bib0220"><span class="elsevierStyleSup">5&#44;25&#44;28</span></a> and amounted to 2&#46;6&#37; of the total in our study&#44; with a significantly increased percentage in preterm births before 25 weeks&#8217; gestation &#40;15&#46;2&#37;&#41;&#46; Another salient finding of our analysis was that 78&#46;2&#37; of intrapartum deaths &#40;18&#47;23&#41; occurred in mothers that were already hospitalised&#44; and the relevance of this finding may be twofold&#46; First&#44; these cases can be monitored more closely before and during labour&#59; and second&#44; parents may be given information before delivery that would usually include a prediction of survival&#44; which should be estimated as soon as there is a risk of preterm birth&#44; and not only when the baby is born alive&#46; For all the above reasons&#44; intrapartum foetal mortality and the associated risk factors are of considerable clinical and epidemiological relevance&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">Numerous authors have analysed maternal and obstetric risk factors associated with foetal mortality&#46;<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">7&#44;29&#44;30</span></a> Some studies have found differences in the risk factors associated with foetal mortality in term versus preterm deliveries&#46;<a class="elsevierStyleCrossRefs" href="#bib0245"><span class="elsevierStyleSup">10&#44;31</span></a> This is also the case with antepartum versus intrapartum foetal mortality&#44; for while they may have similar causes&#44; intrapartum foetal mortality is closely associated with obstetric practices and intrauterine hypoxia&#46;<a class="elsevierStyleCrossRefs" href="#bib0255"><span class="elsevierStyleSup">12&#44;17&#44;28</span></a> However&#44; we did not find any studies that specifically analysed the potential perinatal risk factors associated with intrapartum foetal death in preterm deliveries&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">Some of the risk factors associated to intrapartum foetal mortality are advanced maternal age&#44; multiple pregnancy&#44; lack of prenatal care&#44; premature rupture of membranes or chronic diseases such as obesity&#46;<a class="elsevierStyleCrossRefs" href="#bib0255"><span class="elsevierStyleSup">12&#8211;14</span></a> Other risk factors associated with foetal mortality in preterm deliveries are placental abruption&#44; preeclampsia or intrauterine infection&#46;<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">7&#44;10&#44;11</span></a> In our study&#44; we did not find a significant difference in these risk factors&#44; and while we found a greater percentage of obstetric haemorrhage&#44; chronic maternal disease and chorioamnionitis&#44; these differences were not statistically significant&#46; We did find statistically significant associations with TRA&#44; abnormal foetal ultrasound findings &#40;abnormal Doppler and oligohydramnios&#41;&#44; lower percentage of caesarean deliveries&#44; lower administration of antenatal corticosteroids&#44; lower gestational age and low birth weight&#46; Although performance of caesarean delivery has been associated with a decreased foetal mortality rate&#44;<a class="elsevierStyleCrossRefs" href="#bib0225"><span class="elsevierStyleSup">6&#44;32</span></a> our multivariate analysis did not find it to be an independent risk factor for intrapartum foetal death&#46; Lower gestational age&#44;<a class="elsevierStyleCrossRefs" href="#bib0270"><span class="elsevierStyleSup">15&#44;21</span></a> small for gestational age birth<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">12</span></a> and abnormal foetal ultrasound findings are well-known and thoroughly studied risk factors&#46; An abnormal foetal Doppler ultrasound is a predictor of foetal compromise and perinatal mortality&#44; especially in high-risk pregnancies such as those with placental insufficiency or IUGR&#46;<a class="elsevierStyleCrossRefs" href="#bib0345"><span class="elsevierStyleSup">30&#44;31&#44;33&#44;34</span></a> Both oligohydramnios or polyhydramnios are abnormal and potentially place the foetus at risk&#44; but their impact on foetal mortality remains unclear&#46;<a class="elsevierStyleCrossRef" href="#bib0360"><span class="elsevierStyleSup">33</span></a> However&#44; a recent systematic review suggests that oligohydramnios is associated with increased perinatal mortality&#46;<a class="elsevierStyleCrossRef" href="#bib0370"><span class="elsevierStyleSup">35</span></a></p><p id="par0115" class="elsevierStylePara elsevierViewall">Assisted reproductive technologies are usually associated with advanced maternal age&#44; maternal chronic disease or multiple pregnancy&#44; all of them factors that increase the risk of foetal death&#46; A recent study found that singleton pregnancies achieved through ART carried a higher risk of foetal mortality at 22&#8211;27 weeks&#8217; gestation&#46;<a class="elsevierStyleCrossRef" href="#bib0375"><span class="elsevierStyleSup">36</span></a> However&#44; we did not find any studies that specifically assessed the association between ART and intrapartum mortality&#46; A lack of antenatal corticosteroid treatment in preterm newborns is associated with an increased postnatal mortality and worse short-term and long-term outcomes&#46;<a class="elsevierStyleCrossRefs" href="#bib0380"><span class="elsevierStyleSup">37&#44;38</span></a> But we also found no studies analysing the effect of antenatal corticosteroids on intrapartum foetal mortality&#44; despite the clear association of a lack of exposure with increased foetal mortality&#46; We believe that this is an important aspect&#44; as of all the factors that we identified&#44; this is the only one that can be modified&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">One of the limitations of this study is that we did not analyse the risk factors for antenatal foetal death&#44; which may require specific study in this group of patients&#46; Another limitation is that this was a retrospective hospital-based single-centre study conducted in a facility that manages a high percentage of high-risk pregnancies where the number of foetuses that die during delivery is small&#46; Thus&#44; it would be interesting to conduct broader studies to clarify whether these risk factors have a direct effect on intrapartum mortality or rather reflect a less invasive approach in more premature foetuses with poorer prognoses&#44; as clinical decisions influenced by foetal prognosis may have the most significant impact on the survival of these patients&#46;<a class="elsevierStyleCrossRef" href="#bib0390"><span class="elsevierStyleSup">39</span></a></p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Conclusion</span><p id="par0125" class="elsevierStylePara elsevierViewall">Intrapartum foetal death occurs in a significant number of preterm births&#46; Its study is of great clinical relevance&#44; first&#44; because estimations of survival for preterm newborns should start being made from the moment that there is risk of preterm birth&#59; and secondly&#44; because analysing the factors potentially associated with it may help optimise perinatal care and thus increase the survival of babies born preterm&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Conflict of interests</span><p id="par0130" class="elsevierStylePara elsevierViewall">The authors have no conflict of interests to declare&#46;</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introduction</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Pre-term delivery is one of the leading causes of foetal and perinatal mortality&#46; However&#44; perinatal risk factors associated with intra-partum foetal death in preterm deliveries have not been well studied&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Objective</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">To analyse foetal mortality and perinatal risk factors associated with intra-partum foetal mortality in pregnancies of less than 32 weeks gestational age&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Material and methods</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">The study included all preterm deliveries between 22 and 31 &#43;1 weeks gestational age &#40;WGA&#41;&#44; born in a tertiary-referral hospital&#44; over a period of 7 years &#40;2008&#8211;2014&#41;&#46; A logistic regression model was used to identify perinatal risk factors associated with intra-partum foetal mortality &#40;foetal malformations and chromosomal abnormalities were excluded&#41;&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Results</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">During the study period&#44; the overall foetal mortality was 63&#46;1&#37; &#40;106&#47;168&#41; &#40;&#8805;22 weeks of gestation&#41; and occurred in pregnancies of less than 32 WGA&#46; A total of 882 deliveries between 22 and 31<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>6 weeks of gestation were included for analysis&#46; The rate of foetal mortality was 11&#46;3&#37; &#40;100&#47;882&#41;&#46; The rate of intra-partum foetal death was 2&#46;6&#37; &#40;23&#47;882&#41;&#44; with 78&#46;2&#37; &#40;18&#47;23&#41; of these cases occurring in hospitalised pregnancies&#46; It was found that Assisted Reproductive Techniques&#44; abnormal foetal ultrasound&#44; no administration of antenatal steroids&#44; lower gestational age&#44; and small for gestational age&#44; were independent risk factors associated with intra-partum foetal mortality&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Conclusion</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">This study showed that there is a significant percentage intra-partum foetal mortality in infants between 22 and 31<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>6 WGA&#46; The analysis of intrapartum mortality and risk factors associated with this mortality is of clinical and epidemiological interest to optimise perinatal care and improve survival of preterm infants&#46;</p></span>"
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        "resumen" => "<span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Introducci&#243;n</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">El parto prematuro es una de las principales causas de mortalidad perinatal y fetal&#46; Sin embargo&#44; los factores de riesgo perinatales asociados a mortalidad fetal intraparto en partos pret&#233;rmino no han sido bien analizados&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Objetivo</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Analizar la mortalidad fetal y los factores de riesgo perinatales asociados a mortalidad fetal intraparto en gestaciones de menos de 32 semanas&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Material y m&#233;todos</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Se incluyeron en el an&#225;lisis todos los partos pret&#233;rmino entre las semanas 22 y 31<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>6 d&#237;as&#44; nacidos en un hospital terciario durante un periodo de 7 a&#241;os &#40;2008-2014&#41;&#46; Se realiz&#243; un an&#225;lisis de regresi&#243;n log&#237;stica para identificar factores de riesgo perinatales asociados a mortalidad fetal intraparto &#40;excluidos malformaciones y cromosomopat&#237;as severas&#41;&#46;</p></span> <span id="abst0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Resultados</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">En este per&#237;odo el 63&#44;1&#37; &#40;106&#47;168&#41; de la mortalidad fetal &#40;&#8805;22 semanas&#41; se produjo en gestaciones menores de 32 semanas&#46; Ochocientos ochenta y dos nacimientos entre las semanas 22 y 31<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>6 d&#237;as fueron incluidos en el an&#225;lisis&#46; La mortalidad fetal fue del 11&#44;3&#37; &#40;100&#47;882&#41;&#46; La mortalidad fetal intraparto fue del 2&#44;6&#37; &#40;23&#47;882&#41;&#44; afectando en el 78&#44;2&#37; de los casos &#40;18&#47;23&#41; a gestantes hospitalizadas&#46; Encontramos que las t&#233;cnicas de reproducci&#243;n asistida&#44; la ecograf&#237;a fetal patol&#243;gica&#44; la no administraci&#243;n de corticoides antenatales&#44; la menor edad gestacional y el bajo peso para la edad gestacional fueron factores de riesgo independientes asociados a mortalidad fetal intraparto&#46;</p></span> <span id="abst0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Conclusi&#243;n</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">La mortalidad fetal intraparto afect&#243; a un porcentaje importante de nacimientos entre las semanas 22 y 31<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>6 d&#237;as&#46; El an&#225;lisis de la mortalidad fetal intraparto y los factores de riesgo asociados a esta resulta de gran inter&#233;s cl&#237;nico y epidemiol&#243;gico para optimizar el cuidado perinatal y aumentar la supervivencia del reci&#233;n nacido pret&#233;rmino&#46;</p></span>"
        "secciones" => array:5 [
          0 => array:2 [
            "identificador" => "abst0030"
            "titulo" => "Introducci&#243;n"
          ]
          1 => array:2 [
            "identificador" => "abst0035"
            "titulo" => "Objetivo"
          ]
          2 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "Material y m&#233;todos"
          ]
          3 => array:2 [
            "identificador" => "abst0045"
            "titulo" => "Resultados"
          ]
          4 => array:2 [
            "identificador" => "abst0050"
            "titulo" => "Conclusi&#243;n"
          ]
        ]
      ]
    ]
    "NotaPie" => array:2 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0050"><span class="elsevierStyleItalic">Previous presentation</span>&#58; This study was presented as <span class="elsevierStyleItalic">Risk factors associated with intrapartum stillbirths in preterm babies</span> at the 4th International Congress of UENPS&#59; December 11&#8211;14&#59; Athens&#44; Greece&#46;</p>"
      ]
      1 => array:2 [
        "etiqueta" => "&#9734;&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0055">Please cite this article as&#58; Zeballos Sarrato S&#44; Villar Castro S&#44; Ramos Navarro C&#44; Zeballos Sarrato G&#44; S&#225;nchez Luna M&#46; Factores de riesgo asociados a mortalidad fetal intraparto en reci&#233;n nacidos pret&#233;rmino&#46; An Pediatr &#40;Barc&#41;&#46; 2017&#59;86&#58;127&#8211;134&#46;</p>"
      ]
    ]
    "multimedia" => array:5 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
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        "descripcion" => array:1 [
          "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Antepartum and intrapartum foetal death by gestational age&#46; <span class="elsevierStyleItalic">Y</span> axis&#58; percentage of stillbirths &#40;antepartum and intrapartum death&#41; over the total number of births&#46; <span class="elsevierStyleItalic">X</span> axis&#58; gestational age in weeks&#46;</p>"
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      ]
      1 => array:8 [
        "identificador" => "tbl0005"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at1"
            "detalle" => "Table "
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        "tabla" => array:3 [
          "leyenda" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">n</span>&#44; total number of cases per year&#59; &#40;&#37;&#41;&#58; percentage of foetal deaths in gestations of 22 or fewer weeks&#46;</p>"
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Year&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">2008&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">2009&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">2010&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">2011&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">2012&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">2013&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">2014&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Total&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Total births&#44; <span class="elsevierStyleItalic">n</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8177&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6375&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7707&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6245&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5479&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5416&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5365&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">44&#44;764&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Foetal deaths at &#8805;22 weeks&#44; <span class="elsevierStyleItalic">n</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">29&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">30&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">22&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">24&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">22&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">22&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">19&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">168&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Foetal deaths at 22&#8211;31<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>6 weeks&#44; <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">24 &#40;82&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">20 &#40;66&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">15 &#40;68&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">17 &#40;70&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">14 &#40;63&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7 &#40;35&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9 &#40;47&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">106 &#40;63&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Foetal mortality rate<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a> at &#8805;22<span class="elsevierStyleHsp" style=""></span>weeks&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#46;5&#8240;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#46;7&#8240;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#46;8&#8240;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#46;8&#8240;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#8240;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#46;1&#8240;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#46;5&#8240;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#46;7&#8240;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Foetal mortality rate at 22&#8211;31<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>6 weeks&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#46;9&#8240;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#46;1&#8240;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;9&#8240;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#46;7&#8240;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#46;5&#8240;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;1&#8240;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;6&#8240;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#46;3&#8240;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
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            0 => array:3 [
              "identificador" => "tblfn0005"
              "etiqueta" => "a"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Foetal mortality rates based on WHO recommended definitions &#40;per 1000 births&#41;&#46;</p>"
            ]
          ]
        ]
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          "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Foetal mortality in births at 22 or fewer weeks&#8217; gestation and between 22 and 31<span class="elsevierStyleSup">&#43;6</span> weeks&#8217; gestation &#40;without taking into account the exclusion criteria&#41;&#46;</p>"
        ]
      ]
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        "etiqueta" => "Table 2"
        "tipo" => "MULTIMEDIATABLA"
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          "leyenda" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">CI&#44; confidence interval&#59; <span class="elsevierStyleItalic">n</span>&#44; total number of cases per year&#59; w&#44; weeks&#59; &#40;&#37;&#41;&#58; percentage of foetal deaths and 95&#37; confidence interval by gestational age&#46;</p>"
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Gestational age &#40;weeks&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">22 w<br><span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;<br>&#40;95&#37; CI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">23 w<br><span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;<br>&#40;95&#37; CI&#41;<br>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">24 w<br><span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;<br>&#40;95&#37; CI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">25 w<br><span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;<br>&#40;95&#37; CI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">26 w<br><span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;<br>&#40;95&#37; CI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">27 w<br><span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;<br>&#40;95&#37; CI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">28 w<br><span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;<br>&#40;95&#37; CI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">29 w<br><span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;<br>&#40;95&#37; CI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">30 w<br><span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;<br>&#40;95&#37; CI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">31 w<br><span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;<br>&#40;95&#37; CI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Total<br><span class="elsevierStyleItalic">n</span><br>&#40;&#37;&#41;<br>&#40;95&#37; CI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Total births&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">36&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">61&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">88&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">74&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">98&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">117&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">107&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">130&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">163&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">882&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Foetal deaths&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5<br>&#40;62&#46;5&#41;<br>&#40;24&#46;5&#8211;91&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10<br>&#40;27&#46;7&#41;<br>&#40;11&#46;8&#8211;43&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">12<br>&#40;19&#46;6&#41;<br>&#40;8&#46;9&#8211;30&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11<br>&#40;12&#46;5&#41;<br>&#40;5&#8211;20&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9<br>&#40;12&#46;1&#41;<br>&#40;4&#8211;20&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">12<br>&#40;12&#46;2&#41;<br>&#40;5&#46;2&#8211;19&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13<br>&#40;11&#46;1&#41;<br>&#40;5&#8211;17&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7<br>&#40;6&#46;5&#41;<br>&#40;1&#46;4&#8211;11&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8<br>&#40;6&#46;1&#41;<br>&#40;1&#46;6&#8211;10&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13<br>&#40;8&#41;<br>&#40;3&#46;5&#8211;12&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">100<br>&#40;11&#46;3&#41;<br>&#40;9&#46;2&#8211;13&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Antepartum foetal deaths&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2<br>&#40;25&#41;<br>&#40;3&#46;2&#8211;65&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6<br>&#40;16&#46;6&#41;<br>&#40;3&#46;1&#8211;30&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3<br>&#40;4&#46;9&#41;<br>&#40;1&#8211;13&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9<br>&#40;10&#46;2&#41;<br>&#40;3&#46;3&#8211;17&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9<br>&#40;12&#46;1&#41;<br>&#40;4&#8211;20&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10<br>&#40;10&#46;2&#41;<br>&#40;3&#46;7&#8211;16&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13<br>&#40;11&#46;1&#41;<br>&#40;5&#8211;17&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6<br>&#40;5&#46;6&#41;<br>&#40;0&#46;8&#8211;10&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7<br>&#40;5&#46;4&#41;<br>&#40;1&#46;1&#8211;9&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">12<br>&#40;7&#46;4&#41;<br>&#40;3&#8211;11&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">77<br>&#40;8&#46;7&#41;<br>&#40;6&#46;8&#8211;10&#46;6&#41;<br>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Intrapartum foetal deaths<br>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3<br>&#40;37&#46;5&#41;<br>&#40;8&#46;5&#8211;75&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4<br>&#40;11&#46;1&#41;<br>&#40;3&#46;1&#8211;26&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9<br>&#40;14&#46;7&#41;<br>&#40;5&#8211;24&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2<br>&#40;2&#46;2&#41;<br>&#40;0&#46;3&#8211;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0<br>&#40;0&#41;<br>&#40;0&#8211;4&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2<br>&#40;2&#41;<br>&#40;0&#46;2&#8211;7&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0<br>&#40;0&#41;<br>&#40;0&#8211;3&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1<br>&#40;0&#46;9&#41;<br>&#40;0&#46;1&#8211;5&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1<br>&#40;0&#46;7&#41;<br>&#40;0&#46;02&#8211;4&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1<br>&#40;0&#46;6&#41;<br>&#40;0&#46;02&#8211;3&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">23<br>&#40;2&#46;6&#41;<br>&#40;1&#46;5&#8211;3&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Hospitalised mothers<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">18&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Live births&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3<br>&#40;37&#46;5&#41;<br>&#40;8&#46;5&#8211;75&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">26<br>&#40;72&#46;2&#41;<br>&#40;56&#46;2&#8211;88&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">49<br>&#40;80&#46;3&#41;<br>&#40;69&#46;5&#8211;91&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">77<br>&#40;87&#46;5&#41;<br>&#40;80&#46;5&#8211;95&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">65<br>&#40;87&#46;8&#41;<br>&#40;79&#46;7&#8211;96&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">86<br>&#40;87&#46;7&#41;<br>&#40;80&#46;7&#8211;94&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">104<br>&#40;88&#46;8&#41;<br>&#40;82&#46;8&#8211;95&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">100<br>&#40;93&#46;4&#41;<br>&#40;88&#46;3&#8211;98&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">122<br>&#40;93&#46;9&#41;<br>&#40;89&#46;3&#8211;98&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">150<br>&#40;92&#41;<br>&#40;87&#46;6&#8211;96&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">782<br>&#40;88&#46;7&#41;<br>&#40;86&#46;5&#8211;90&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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          "en" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Foetal mortality &#40;antepartum and intrapartum&#41; and live births by gestational age&#46;</p>"
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          "leyenda" => "<p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">IUGR&#44; intrauterine growth restriction&#59; n&#44; total number of patients in each group&#59; ROM&#44; rupture of membranes&#59; &#40;&#37;&#41;&#44; percentage of the total of live births or intrapartum foetal deaths&#44; by column&#46;</p>"
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Prenatal variables under study&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Live births&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Intrapartum foetal deaths&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">P</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Total births&#44; n</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">782&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">23&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Maternal age in years&#44; mean</span><span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">SD</span><a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">32&#46;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>6&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">33&#46;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>5&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;24&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Prenatal care&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">749 &#40;95&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">23 &#40;100&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;092&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Maternal disease during gestation</span><a class="elsevierStyleCrossRef" href="#tblfn0025"><span class="elsevierStyleSup">c</span></a>&#44; <span class="elsevierStyleItalic">n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">317 &#40;41&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">12 &#40;52&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;30&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Preeclampsia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">113 &#40;14&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4 &#40;17&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;70&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Gestational diabetes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">59 &#40;7&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1 &#40;4&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;55&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Obstetric haemorrhage&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">69 &#40;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4 &#40;17&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;06&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Unfavourable obstetric history&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">97 &#40;12&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3 &#40;13&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;94&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Chronic disease&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">78 &#40;10&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5 &#40;21&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;07&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Assisted reproductive technology &#40;ART&#41;&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">163 &#40;20&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10 &#40;41&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;01<a class="elsevierStyleCrossRef" href="#tblfn0035"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Multiple pregnancy&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">296 &#40;37&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11 &#40;47&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;33&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Abnormal foetal ultrasound</span><a class="elsevierStyleCrossRef" href="#tblfn0025"><span class="elsevierStyleSup">c</span></a>&#44; <span class="elsevierStyleItalic">n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">254 &#40;32&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">15 &#40;65&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;001<a class="elsevierStyleCrossRef" href="#tblfn0035"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>IUGR with normal Doppler&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">39 &#40;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 &#40;8&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;75&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>IUGR with abnormal Doppler<a class="elsevierStyleCrossRef" href="#tblfn0030"><span class="elsevierStyleSup">d</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">77 &#40;9&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4 &#40;17&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Abnormal Doppler <a class="elsevierStyleCrossRef" href="#tblfn0030"><span class="elsevierStyleSup">d</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">25 &#40;3&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4 &#40;17&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;04<a class="elsevierStyleCrossRef" href="#tblfn0035"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Oligohydramnios&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">140 &#40;18&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10 &#40;43&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;002<a class="elsevierStyleCrossRef" href="#tblfn0035"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Polyhydramnios&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10 &#40;1&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1 &#40;4&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;60&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Caesarean delivery&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">491 &#40;62&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7 &#40;30&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;002<a class="elsevierStyleCrossRef" href="#tblfn0035"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">ROM latency</span><span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">1</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">h&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">285 &#40;36&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11 &#40;47&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;26&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">ROM latency&#44; median &#40;Q1&#8211;Q3&#41;</span><a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">72 &#40;13&#8211;220&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">144 &#40;12&#8211;270&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;47&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Maternal antibiotherapy&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">464 &#40;59&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">15 &#40;65&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;57&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Suspectedchorioamnionitis&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">192 &#40;24&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9 &#40;39&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Antenatal corticosteroids &#40;at least one dose&#41;&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">713 &#40;91&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8 &#40;34&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001<a class="elsevierStyleCrossRef" href="#tblfn0035"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Full course&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">393 &#40;50&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5 &#40;21&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;011<a class="elsevierStyleCrossRef" href="#tblfn0035"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Partial course &#40;one dose&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">160 &#40;20&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1 &#40;4&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Corticosteroids<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>7 days&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">160 &#40;20&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 &#40;8&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;21&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>No dose&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">69 &#40;8&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">15 &#40;65&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001<a class="elsevierStyleCrossRef" href="#tblfn0035"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Gestational age &#40;weeks</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">&#43;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">days&#41;&#44; median &#40;Q1&#8211;Q3&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">28<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>5 &#40;26<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>3&#59; 30<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">24<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>4 &#40;24&#59; 27&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001<a class="elsevierStyleCrossRef" href="#tblfn0035"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Birth weight &#40;g&#41;&#44; mean</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">&#177;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">SD</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1100<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>379<span class="elsevierStyleHsp" style=""></span>g&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">650<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>210<span class="elsevierStyleHsp" style=""></span>g&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001<a class="elsevierStyleCrossRef" href="#tblfn0035"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Small for gestational age&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">69 &#40;8&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6 &#40;26&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;005<a class="elsevierStyleCrossRef" href="#tblfn0035"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Male sex&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">416 &#40;53&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13 &#40;56&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;75&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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            0 => array:3 [
              "identificador" => "tblfn0015"
              "etiqueta" => "a"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0015">Mean<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>standard deviation&#46;</p>"
            ]
            1 => array:3 [
              "identificador" => "tblfn0020"
              "etiqueta" => "b"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0020">Median &#40;first and third quartiles&#41;&#46;</p>"
            ]
            2 => array:3 [
              "identificador" => "tblfn0025"
              "etiqueta" => "c"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0025">Cases in which the value of the analysed factor was unknown in the column of live births&#46; Percentage based on the denominator adjusted for these missing data&#58; maternal disease during pregnancy &#40;10 cases&#41;&#44; gestational diabetes &#40;16 cases&#41;&#44; preeclampsia &#40;10 cases&#41;&#44; and abnormal foetal ultrasound &#40;6 cases&#41;&#46;</p>"
            ]
            3 => array:3 [
              "identificador" => "tblfn0030"
              "etiqueta" => "d"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0030">We conducted the statistical analysis by grouping all patients with abnormal Doppler in each column &#40;abnormal Doppler and IUGR with abnormal Doppler&#41;&#58; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;3&#42;&#46;</p>"
            ]
            4 => array:3 [
              "identificador" => "tblfn0035"
              "etiqueta" => "&#42;"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0035">Statistically significant&#46;</p>"
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Comparison of the perinatal risk factors under study between live births and intrapartum foetal deaths at fewer than 32 weeks&#8217; gestation&#46;</p>"
        ]
      ]
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        "etiqueta" => "Table 4"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
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        "detalles" => array:1 [
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            "identificador" => "at4"
            "detalle" => "Table "
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                0 => """
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                      "titulo" => "Fetal death"
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                          "autores" => array:1 [
                            0 => "R&#46;M&#46; Silver"
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                      "doi" => "10.1097/01.AOG.0000248537.89739.96"
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                        "volumen" => "109"
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                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17197601"
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                0 => array:1 [
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Article information

ISSN: 23412879
Original language: English

DOI:10.1016/j.anpede.2016.04.007

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Year/Month	Html	Pdf	Total

2024 November	11	10	21
2024 October	55	29	84
2024 September	52	37	89
2024 August	57	65	122
2024 July	52	28	80
2024 June	69	31	100
2024 May	48	32	80
2024 April	63	43	106
2024 March	46	27	73
2024 February	45	28	73
2024 January	44	21	65
2023 December	39	17	56
2023 November	42	22	64
2023 October	46	26	72
2023 September	26	22	48
2023 August	30	18	48
2023 July	26	17	43
2023 June	39	30	69
2023 May	49	22	71
2023 April	21	16	37
2023 March	56	25	81
2023 February	36	25	61
2023 January	22	20	42
2022 December	66	50	116
2022 November	54	43	97
2022 October	82	51	133
2022 September	33	36	69
2022 August	33	44	77
2022 July	36	38	74
2022 June	32	37	69
2022 May	40	49	89
2022 April	29	28	57
2022 March	44	48	92
2022 February	53	32	85
2022 January	54	34	88
2021 December	39	34	73
2021 November	38	43	81
2021 October	82	82	164
2021 September	29	29	58
2021 August	32	44	76
2021 July	30	41	71
2021 June	67	36	103
2021 May	48	57	105
2021 April	123	56	179
2021 March	41	41	82
2021 February	27	25	52
2021 January	30	30	60
2020 December	24	23	47
2020 November	30	25	55
2020 October	25	24	49
2020 September	43	22	65
2020 August	19	20	39
2020 July	29	27	56
2020 June	46	16	62
2020 May	48	16	64
2020 April	36	18	54
2020 March	38	20	58
2020 February	35	13	48
2020 January	22	19	41
2019 December	32	26	58
2019 November	18	17	35
2019 October	20	16	36
2019 September	27	11	38
2019 August	45	22	67
2019 July	36	25	61
2019 June	29	23	52
2019 May	40	16	56
2019 April	34	27	61
2019 March	30	17	47
2019 February	33	21	54
2019 January	23	14	37
2018 December	39	30	69
2018 November	41	28	69
2018 October	36	22	58
2018 September	27	16	43
2018 August	4	0	4
2018 July	1	0	1
2018 June	2	0	2
2018 May	3	0	3
2018 April	19	0	19
2018 March	10	0	10
2018 February	8	0	8
2018 January	18	0	18
2017 December	17	0	17
2017 November	17	0	17
2017 October	18	0	18
2017 September	14	0	14
2017 August	11	0	11
2017 July	13	0	13
2017 June	27	7	34
2017 May	43	11	54
2017 April	101	89	190
2017 March	30	21	51
2017 February	10	12	22

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