Neonatal morbidity and mortality associated with low adherence to prenatal corticosteroids

array:24 ["pii" => "S2341287919301115" "issn" => "23412879" "doi" => "10.1016/j.anpede.2018.11.015" "estado" => "S300" "fechaPublicacion" => "2019-08-01" "aid" => "2560" "copyrightAnyo" => "2019" "documento" => "article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "fla" "cita" => "An Pediatr (Barc). 2019;91:105-11" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 512 "formatos" => array:3 [ "EPUB" => 58 "HTML" => 357 "PDF" => 97 ] ] "Traduccion" => array:1 [ "es" => array:20 [ "pii" => "S1695403318305411" "issn" => "16954033" "doi" => "10.1016/j.anpedi.2018.11.011" "estado" => "S300" "fechaPublicacion" => "2019-08-01" "aid" => "2560" "copyright" => "Asociación Española de Pediatría" "documento" => "article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "fla" "cita" => "An Pediatr (Barc). 2019;91:105-11" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 1961 "formatos" => array:3 [ "EPUB" => 88 "HTML" => 1416 "PDF" => 457 ] ] "es" => array:13 [ "idiomaDefecto" => true "cabecera" => "Original" "titulo" => "Morbimortalidad neonatal en un entorno de baja adherencia a corticosteroides prenatales" "tienePdf" => "es" "tieneTextoCompleto" => "es" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "105" "paginaFinal" => "111" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Neonatal morbidity and mortality associated with low adherence to prenatal corticosteroids" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2386 "Ancho" => 2925 "Tamanyo" => 326613 ] ] "descripcion" => array:1 [ "es" => "Supervivencia de recién nacidos prematuros hospitalizados en función de la administración de corticosteroides prenatales, con latencia ≥48horas, y en subgrupo de pacientes<34 semanas. Supervivencia de pacientes prematuros hospitalizados (n=1.083) RN prematuros con corticosteroides vs. sin corticosteroides (n=1.083) p=0,30 (Log Rank) RN prematuros con corticosteroides con latencia≥48h vs. sin corticosteroides (n=778) p=0,34 (Log Rank) RN<34 semanas con corticosteroides con latencia≥48h vs. RN<34 semanas sin corticosteroides (n=310) p=0,009 (Log Rank)." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Rene O. Pérez-Ramírez, Juan Carlos Lona-Reyes, Cesar A. Ochoa-Meza, Larissa M. Gómez-Ruiz, Ruth Y. Ramos-Gutiérrez, E. Elizabeth Camarena-Pulido, J. Antonio Gallegos-Marín" "autores" => array:7 [ 0 => array:2 [ "nombre" => "Rene O." "apellidos" => "Pérez-Ramírez" ] 1 => array:2 [ "nombre" => "Juan Carlos" "apellidos" => "Lona-Reyes" ] 2 => array:2 [ "nombre" => "Cesar A." "apellidos" => "Ochoa-Meza" ] 3 => array:2 [ "nombre" => "Larissa M." "apellidos" => "Gómez-Ruiz" ] 4 => array:2 [ "nombre" => "Ruth Y." "apellidos" => "Ramos-Gutiérrez" ] 5 => array:2 [ "nombre" => "E. Elizabeth" "apellidos" => "Camarena-Pulido" ] 6 => array:2 [ "nombre" => "J. Antonio" "apellidos" => "Gallegos-Marín" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2341287919301115" "doi" => "10.1016/j.anpede.2018.11.015" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341287919301115?idApp=UINPBA00005H" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1695403318305411?idApp=UINPBA00005H" "url" => "/16954033/0000009100000002/v1_201908020636/S1695403318305411/v1_201908020636/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S2341287919301061" "issn" => "23412879" "doi" => "10.1016/j.anpede.2018.11.013" "estado" => "S300" "fechaPublicacion" => "2019-08-01" "aid" => "2559" "documento" => "article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "fla" "cita" => "An Pediatr (Barc). 2019;91:112-9" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 1117 "formatos" => array:3 [ "EPUB" => 63 "HTML" => 835 "PDF" => 219 ] ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "Original Article" "titulo" => "What is the optimal flow on starting high-flow oxygen therapy for bronchiolitis treatment in paediatric wards?" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "112" "paginaFinal" => "119" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "¿Cuál es el flujo inicial idóneo en la oxigenoterapia de alto flujo para el tratamiento de la bronquiolitis en las plantas de hospitalización?" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1913 "Ancho" => 2826 "Tamanyo" => 194444 ] ] "descripcion" => array:1 [ "en" => "Changes in the heart rate and respiratory rate severity parameters by initial flow rate. HFNC, high-flow oxygen therapy with nasal cannula; HR, heart rate; RR, respiratory rate. *Statistically significant." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Felipe González Martínez, María Isabel González Sánchez, Jimena Pérez-Moreno, Blanca Toledo del Castillo, Rosa Rodríguez Fernández" "autores" => array:5 [ 0 => array:2 [ "nombre" => "Felipe" "apellidos" => "González Martínez" ] 1 => array:2 [ "nombre" => "María Isabel" "apellidos" => "González Sánchez" ] 2 => array:2 [ "nombre" => "Jimena" "apellidos" => "Pérez-Moreno" ] 3 => array:2 [ "nombre" => "Blanca" "apellidos" => "Toledo del Castillo" ] 4 => array:2 [ "nombre" => "Rosa" "apellidos" => "Rodríguez Fernández" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S169540331830540X" "doi" => "10.1016/j.anpedi.2018.11.010" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S169540331830540X?idApp=UINPBA00005H" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341287919301061?idApp=UINPBA00005H" "url" => "/23412879/0000009100000002/v1_201908020803/S2341287919301061/v1_201908020803/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S2341287919301073" "issn" => "23412879" "doi" => "10.1016/j.anpede.2018.11.014" "estado" => "S300" "fechaPublicacion" => "2019-08-01" "aid" => "2561" "documento" => "article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "fla" "cita" => "An Pediatr (Barc). 2019;91:96-104" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 437 "formatos" => array:3 [ "EPUB" => 44 "HTML" => 292 "PDF" => 101 ] ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "Original Article" "titulo" => "Factors associated with the prevalence of hypovitaminosis D in pregnant women and their newborns" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "96" "paginaFinal" => "104" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Factores asociados a la prevalencia de hipovitaminosis D en mujeres embarazadas y sus recién nacidos" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1767 "Ancho" => 2673 "Tamanyo" => 130432 ] ] "descripcion" => array:1 [ "en" => "Mean vitamin D levels in maternal blood and umbilical cord blood by month of delivery." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Elizabeth Blarduni, Arantzazu Arrospide, Mar Galar, Luis Castaño, Javier Mar" "autores" => array:6 [ 0 => array:2 [ "nombre" => "Elizabeth" "apellidos" => "Blarduni" ] 1 => array:2 [ "nombre" => "Arantzazu" "apellidos" => "Arrospide" ] 2 => array:2 [ "nombre" => "Mar" "apellidos" => "Galar" ] 3 => array:2 [ "nombre" => "Luis" "apellidos" => "Castaño" ] 4 => array:2 [ "nombre" => "Javier" "apellidos" => "Mar" ] 5 => array:1 [ "colaborador" => "GOIVIDE Group" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S1695403318305423" "doi" => "10.1016/j.anpedi.2018.11.012" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1695403318305423?idApp=UINPBA00005H" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341287919301073?idApp=UINPBA00005H" "url" => "/23412879/0000009100000002/v1_201908020803/S2341287919301073/v1_201908020803/en/main.assets" ] "en" => array:20 [ "idiomaDefecto" => true "cabecera" => "Original Article" "titulo" => "Neonatal morbidity and mortality associated with low adherence to prenatal corticosteroids" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "105" "paginaFinal" => "111" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Rene O. Pérez-Ramírez, Juan Carlos Lona-Reyes, Cesar A. Ochoa-Meza, Larissa M. Gómez-Ruiz, Ruth Y. Ramos-Gutiérrez, E. Elizabeth Camarena-Pulido, J. Antonio Gallegos-Marín" "autores" => array:7 [ 0 => array:3 [ "nombre" => "Rene O." "apellidos" => "Pérez-Ramírez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] 1 => array:4 [ "nombre" => "Juan Carlos" "apellidos" => "Lona-Reyes" "email" => array:1 [ 0 => "carloslona5@hotmail.com" ] "referencia" => array:3 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 2 => array:3 [ "nombre" => "Cesar A." "apellidos" => "Ochoa-Meza" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] 3 => array:3 [ "nombre" => "Larissa M." "apellidos" => "Gómez-Ruiz" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] 4 => array:3 [ "nombre" => "Ruth Y." "apellidos" => "Ramos-Gutiérrez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] 5 => array:3 [ "nombre" => "E. Elizabeth" "apellidos" => "Camarena-Pulido" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] 6 => array:3 [ "nombre" => "J. Antonio" "apellidos" => "Gallegos-Marín" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Hospital Civil de Guadalajara Dr. Juan I. Menchaca, División de Pediatría, Guadalajara, Jalisco, Mexico" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Centro Universitario de Tonalá, Universidad de Guadalajara, Tonalá, Jalisco, Mexico" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Morbimortalidad neonatal en un entorno de baja adherencia a corticosteroides prenatales" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2374 "Ancho" => 2945 "Tamanyo" => 232086 ] ] "descripcion" => array:1 [ "en" => "Survival of hospitalised preterm newborns by administration of antenatal corticosteroids, with a latency period of 48 or more hours, and in the subset of newborns born before 34 weeks’ gestation. Survival of hospitalised preterm newborns (n=1083). Preterm newborns exposed to corticosteroids vs not exposed (n=1083), P=.30 (log rank). Preterm newborns treated with corticosteroids with a latency period ≥48h vs not treated with corticosteroids (n=778), P=.34 (log-rank test). Preterm newborns born before 34 weeks that received corticosteroids with a latency period ≥48h vs preterm newborns <34 weeks not treated with corticosteroids (n=310), P=.009 (log-rank test)." ] ] ] "textoCompleto" => "IntroductionIn recent decades, the risk of death during the neonatal period has decreased by 28% worldwide from 33.2 to 23.9 deaths per 1000 live births,<a class="elsevierStyleCrossRef" href="#bib0140">1</a> although the number of deaths continues to be higher in low-income countries.<a class="elsevierStyleCrossRef" href="#bib0145">2</a> One of the interventions proposed for performance during labour with the aim of reducing neonatal mortality is administration of antenatal corticosteroids.<a class="elsevierStyleCrossRef" href="#bib0150">3</a>The administration of corticosteroids is mainly recommended in women at risk of preterm birth before 34 weeks’ gestation,<a class="elsevierStyleCrossRefs" href="#bib0155">4–6</a> but beneficial effects have been described even in late-preterm newborns.<a class="elsevierStyleCrossRefs" href="#bib0170">7,8</a> There is evidence that their administration significantly reduces the risk of perinatal death, respiratory distress syndrome (RDS), intraventricular haemorrhage (IVH), necrotising enterocolitis, retinopathy of prematurity, systemic infection,<a class="elsevierStyleCrossRefs" href="#bib0180">9–11</a> neurodevelopmental abnormalities and cerebral palsy,<a class="elsevierStyleCrossRef" href="#bib0195">12</a> but most studies have been conducted in first world countries, so the outcomes in developing countries could be different.<a class="elsevierStyleCrossRefs" href="#bib0180">9,13</a>The corticosteroids that cross the placental barrier and may be used for this purpose are betamethasone and dexamethasone.<a class="elsevierStyleCrossRefs" href="#bib0160">5,14–16</a> Their effect peaks 24–48h after administration,<a class="elsevierStyleCrossRef" href="#bib0165">6</a> but some authors have described the use of incomplete courses or schemes with a short interval between doses with inconsistent results.<a class="elsevierStyleCrossRef" href="#bib0220">17</a>The aim of our study was to measure the frequency of the use of antenatal corticosteroids and estimate their effect on the morbidity and mortality of preterm newborns in a neonatal care unit in western Mexico.MethodsWe conducted a retrospective cohort study at the Hospital Civil de Guadalajara Dr. Juan I. Menchaca (HCGJIM) in the city of Guadalajara in Jalisco, Mexico. Our hospital provides health care services to the uninsured and low-income population. The department of obstetrics includes the labour and delivery unit (12 beds, 3 operating rooms and 3 delivery rooms) and the inpatient unit (91 beds); the department of neonatology includes 18 neonatal intensive care beds and 57 intermediate care beds.We selected patients from the cohort of patients documented in the records between January 25, 2016 and August 31, 2017, which include information on the demographic and clinical characteristics, morbidity and mortality of all children born in the hospital (date of birth, sex, gestational age, 5-minute Apgar score, mode of delivery, use of antenatal corticosteroids, death during hospitalisation, cause of death, maternal risk factors for neonatal infection and maternal age).From this study universe, we selected the newborns delivered before 37 weeks’ gestation that were admitted to the neonatal unit after birth, excluding newborns transferred from other units in the hospital or born outside the period under study. We calculated the sample size needed to identify an OR of 0.5,<a class="elsevierStyleCrossRef" href="#bib0180">9</a> assuming the known proportion of death in hospitalised newborns in our hospital of 12.5%,<a class="elsevierStyleCrossRef" href="#bib0225">18</a> for an alfa of 0.05 and a power of 0.80.We made a retrospective review of maternal records to obtain data on the prescription and administration of antenatal corticosteroids (type of corticosteroids, dosage, number of doses and latency period; latency period was defined as the number of hours elapsed from administration to the first dose of corticosteroids to the time of delivery). The drugs were prescribed by the gynaecologists-obstetricians of the hospital in compliance with the clinical practice guidelines of the Secretariat of Health (betamethasone or dexamethasone, 2 intramuscular 12mg doses given 12–24h apart).<a class="elsevierStyleCrossRef" href="#bib0230">19</a>We reviewed the health records of the newborns to find out whether they presented any of the following during hospitalisation: RDS, IVH, early-onset neonatal sepsis (EONS), late-onset neonatal sepsis (LONS) and chronic lung disease (CLD).DefinitionsWe obtained information on RDS, IVH, EONS, LONS and CLD from the patient health records. The physicians in charge of the patient made the diagnoses according to the following definitions:<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005">-Respiratory distress syndrome: progressive breathing difficulty from the first minutes of life with increasing oxygen requirements and radiologic findings associated with increased alveolar surface tension.</li><li class="elsevierStyleListItem" id="lsti0010">-Intraventricular haemorrhage: bleeding confined to the cerebral ventricles, diagnosis made by ultrasound scan performed by a radiologist and severity graded according to the Papile classification.</li><li class="elsevierStyleListItem" id="lsti0015">-Neonatal sepsis: presence of microbial growth in culture of blood or cerebrospinal fluid (CSF) samples from the patient and clinical manifestations suggestive of infection. In cases where the bacterium isolated from blood or CSF was coagulase-negative Staphylococcus, diagnosis required 2 or more positive blood cultures or detection of abnormal white blood cell counts and glucose levels in CSF analysis. Sepsis was classified as early-onset if it manifested in the first 72h of life, and as late-onset otherwise.</li><li class="elsevierStyleListItem" id="lsti0020">-Chronic lung disease: oxygen dependency at 36 weeks of postmenstrual age or at hospital discharge in preterm newborns delivered before 32 weeks’ gestation; in patients delivered at 32 weeks’ gestation or later, it was diagnosed if they were oxygen-dependent for more than 28 days post birth.</li><li class="elsevierStyleListItem" id="lsti0025">-Cause of death (primary cause): illness or lesion that started the chain of pathological events that led to death. It was assessed by 3 paediatric neonatologists and the cause was assigned if there was agreement in 2 or more of their opinions.</li></ul>Statistical analysisWe performed a descriptive analysis of the total sample and then we classified the cohort according to the history of antenatal corticosteroid administration. We summarised qualitative variables as absolute frequencies and quantitative variables as mean, standard deviation (SD) and range. We compared proportions with the chi square test or the Fisher exact test and means with the Student t test or the Fisher exact test. We defined statistical significance as a P-value of less than .05.We analysed the association between administration of antenatal corticosteroids and the dependent variables by means of the chi square test, followed by a logistic regression analysis in which we adjusted the groups by birth weight and gestational age. We performed these analyses for the overall sample and for the subset of patients born before 34 weeks’ gestation. To analyse the impact of corticosteroids across time, we performed a survival analysis, plotting Kaplan–Meier curves and using the log-rank test for hypothesis testing.We used the IBM SPSS Statistics software version 20 for the analysis. The project was approved by the ethics and research committees of the HCGJIM under file number 0184/17.ResultsDuring the period under study, the unit admitted 1083 preterm newborns, 53.3% (n=577) male, 46.4% (n=503) female, and 3 with ambiguous genitalia. Their mean gestational age was 33.4 weeks (maximum, 36.6; minimum, 24; SD, 2.73); 46.6% (n=505) were born before 34 weeks’ gestation and 25.3% (n=274) at or before 32 weeks’ gestation. The mean birth weight was 1765.1g (maximum, 3775; minimum, 410; SD, 606.8). Of all newborns, 70.7% (n=766) were born by caesarean section.Antenatal corticosteroids were given to 42% of the sample (455/1083): dexamethasone to 76.9% (n=350) and betamethasone to 23.1% (n=105); the full course of treatment was only completed in 61.3% of these patients (279/455). Of all newborns delivered before 34 weeks’ gestation, 53.7% had been exposed to corticosteroids (271/505).In our sample, 35% (n=379) of newborns developed RDS, 4.4% (n=48) EONS and 10.7% (n=116) LONS. A transfontanellar ultrasound was performed in 83.8% (n=908), which led to identification of IVH in 15.1% (137/908), the severity of IVH was grade i in 33.5%, ii in 27%, iii in 23.4% and iv in 16.1%.The length of stay was of 28 days or longer in 29.6% of the sample (n=321); within this subset, 51.4% (165/321) had CLD. We ruled out CLD in all preterm newborns discharged before 28 days post birth, as they were all discharged home without a prescription for supplemental oxygen.The mortality in our sample was 22.3% (n=242), and the leading causes of death were infection (28.9%; n=70), respiratory distress syndrome (23.6%; n=57), congenital malformations or genetic disorders (20.7%; n=50) and intraventricular haemorrhage (8.7%; n=21).When we compared gestational age subgroups (<28 weeks [n=50], 28–32 weeks [n=224], 32.1–33.9 weeks [n=231] and ≥34 weeks [n=578]), we found significant differences in mortality (94%, 44.2%, 17.3%, 9.7%; P<.001); respiratory distress syndrome (76%, 77.2%, 38.5%, 13.7%; P<.001); chronic lung disease at 28 days post birth or later (42.9%, 56%, 21.2%, 7.6%; P<.001) and intraventricular haemorrhage (66.7%, 35.7%, 9.3%, 6.1%; P<.001).When we compared the clinical and demographic characteristics based on the administration of antenatal corticosteroids, we found that patients that received this intervention had a lower gestational age and weight at birth and were more likely to have been delivered by caesarean section and have mothers with risk factors for neonatal infection (urinary tract infection, chorioamnionitis, premature rupture of membranes or fever during labour) (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>).<elsevierMultimedia ident="tbl0005"></elsevierMultimedia>The analysis of the frequency of RDS, EONS, LONS, IVH, CLD and death by antenatal corticosteroid use did not reveal a protective effect of this intervention, regardless of the administered dose or schedule; in fact, we found an increased incidence of RDS, IVH and in patients exposed to corticosteroids (<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>). When we analysed the outcomes of this intervention adjusted for gestational age and birth weight for the total sample and the subgroup born before 34 weeks’ gestation, we only found a reduction in mortality (37%) in newborns delivered before 34 weeks’ gestation (<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>).<elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="tbl0015"></elsevierMultimedia>In the group of patients exposed to corticosteroids, 51.9% (236/455) had latency periods of 24h or longer, and only 32.9% (150/455) of 48h or longer; in 32 patients, the health records did not have the information necessary to estimate the duration of latency. When we compared patients that received corticosteroids with a latency of 48h or greater and patients that did not receive corticosteroids, we found a decreased risk of death (60%) in patients that received corticosteroids born before 34 weeks’ gestation, without other significant effects on the remaining outcomes (<a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a>); we also found a protective trend that was not significant on the incidence of IVH of grades iii and iv in patients born before 34 weeks’ gestation (OR, 0.35; 95% CI, 0.11–1.07; P=.06). When we analysed the dependent variables in relation to a latency period of 24h or more, we found no differences in outcomes when we compared patients treated with corticoids and untreated patients.<elsevierMultimedia ident="tbl0020"></elsevierMultimedia>We did not find significant differences in morbidity and mortality between patients with latency periods of 48h or longer treated with betamethasone vs dexamethasone, although there were few patients in this subset.We used Kaplan–Meier survival analysis to assess the effect of antenatal corticosteroids in the survival of preterm newborns admitted to the HCGJIM, and found that the intervention was most beneficial in infants born before 34 week's gestation with latency periods of 48h or longer (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>).<elsevierMultimedia ident="fig0005"></elsevierMultimedia>DiscussionIt is estimated that 10% of infants worldwide are born preterm,<a class="elsevierStyleCrossRef" href="#bib0235">20</a> and that this group has a greater morbidity and mortality compared to full-term infants.<a class="elsevierStyleCrossRef" href="#bib0225">18</a> In Mexico, based on this proportion and the number of births recorded between 2014 and 2016,<a class="elsevierStyleCrossRef" href="#bib0240">21</a> there would be an average of 237000 preterm births per year.Since 1972, there has been evidence that in preterm newborns, antenatal exposure to corticosteroids reduced the risk of neonatal death through their acceleration of foetal lung maturation,<a class="elsevierStyleCrossRefs" href="#bib0155">4,9</a> yet to date adherence to the recommendation of this intervention has been variable. In our study, we found that fewer than 50% of preterm newborns had been exposed to antenatal corticosteroids, and that only 25.8% had received the full course of steroids and only 13.8% the full course with latency periods of 48h or longer.A trial conducted by Berrueta et al.<a class="elsevierStyleCrossRef" href="#bib0245">22</a> in low- and middle-income countries revealed that despite the existence of guidelines for antenatal corticosteroid therapy, this intervention was only performed in 2% to 44% of mothers of preterm babies, with the lowest frequencies found in African countries.Aleman et al.<a class="elsevierStyleCrossRef" href="#bib0250">23</a> found that in Mexico, 70% of women in preterm labour received antenatal corticosteroids, and that this proportion was lower in the group of mothers with comorbidities (39–62.2%). In addition, the frequency of antenatal corticosteroid therapy was significantly higher in El Salvador and Ecuador.Roberts et al. found that antenatal steroids, compared to placebo, decreased the risk of perinatal death (RR, 0.72, 95% CI 0.58 to 0.89), respiratory distress syndrome (RR, 0.66; 95% CI, 0.56–0.77), intraventricular haemorrhage (RR, 0.55; 95% CI: 0.40–0.76), and systemic infection in the first 48h post birth (RR, 0.60; 95% CI: 0.41–0.88). They concluded that there was sufficient evidence to recommend this intervention; however, given that most studies have been conducted in developed countries, there is little evidence on the outcomes of this intervention in low-income countries, where the incidence of infection is high.<a class="elsevierStyleCrossRef" href="#bib0180">9</a>Previous studies suggest that the greatest benefit of antenatal corticosteroids is achieved when birth occurs 24–48h after the administration of the first dose.<a class="elsevierStyleCrossRefs" href="#bib0165">6,24</a> In our study, we found a significant decrease in the risk of mortality (37%) associated with the use of antenatal corticosteroids in the group of patients born before 34 weeks’ gestation, and when we analysed the specific subset with a latency period of 48 or more hours, we found an even greater decrease in risk (60%); we did not find statistically significant differences in the incidence of RDS, EONS, LONS, IVH or CLD.It is likely that in our patients in the HCGJIM, the limited impact on neonatal mortality was due to the low proportion of preterm newborns that had been subject to this intervention with latency periods greater than 24–48h, although it would be necessary to evaluate the effect of other interventions, such as prenatal care, the treatment of maternal comorbidities, the appropriate delivery of neonatal intensive care, the administration of surfactant and the prophylactic use of caffeine.When we assessed the effecs of the intervention by gestational age groups without adjusting for any other variables, we found the greatest benefit in newborns delivered between 32 and 33.9 weeks’ gestation (n=231) in terms of a reduction in neonatal mortality (OR, 0.41; 95% CI, 0.20–0.85). We did not find significant changes in mortality in any subgroup. Our findings were consistent with those of Gyamfi-Bannerman et al.,<a class="elsevierStyleCrossRef" href="#bib0175">8</a> who did not find changes in mortality in late preterm newborns in association with exposure to antenatal corticosteroids; however, these authors did observe a reduction in the incidence of respiratory disease.Norman et al.<a class="elsevierStyleCrossRef" href="#bib0260">25</a> evaluated the effect of antenatal corticosteroids based on the time elapsed from administration of the first dose to birth and found a stronger impact on mortality when the latency period was greater than 24h (OR, 0.5; 95% CI, 0.4–0.6). Nevertheless, their findings suggested that a latency period of 3h can already reduce risk (26%). The authors did not find any decreases in morbidity in patients with latency periods greater than 7 days.In a study of low- and middle-income countries, Althabe et al.<a class="elsevierStyleCrossRef" href="#bib0265">26</a> did not find a decrease in the risk of neonatal death (RR, 0.96, 95% CI, 0.87–1.06) after increasing the frequency of administration of antenatal corticosteroids from 10% to 45%, but they found an increase in mortality in exposed patients of 12.7% (from 23.9 deaths per 1000 live births to 27.4 deaths per 1000 live births; P=.01). There was also an increase in the incidence of maternal infection (RR, 1.45; 95% CI, 1.33–1.58).A secondary analysis by these authors suggested that the increase in mortality was associated with deaths due to bacterial infection (RR, 1.36; 95% CI, 1.12–1.65).<a class="elsevierStyleCrossRef" href="#bib0270">27</a> In our patients at the HCGJIM, we found that the risk of death due to bacterial infection increased as gestational age decreased (RR, 1.17; 95% CI, 1.09–1.26), and found no correlation with the use of antenatal corticosteroids (RR, 1.34; 95% CI, 0.81–2.20).Similar to what we found in our patients, Sasaki et al.<a class="elsevierStyleCrossRef" href="#bib0185">10</a> described a frequency of corticosteroid use in preterm newborns delivered before 34 weeks’ gestation of 40.6% and a significant reduction in neonatal mortality, with no associated reduction in the incidence of RDS. When they analysed outcomes based on mode of delivery, they found that administration of antenatal corticosteroids was associated with a reduced risk of RDS in newborns product of vaginal deliveries. In our study at the HCGJIM, when we adjusted the analysis of outcomes based on mode of delivery we found no changes in the risk of RDS (OR, 1.12; 95% CI, 0.82–1.53).The main limitation of this study is the low number of patients that completed the full course of antenatal corticosteroids or with latency periods of 48h or greater. Given that we only included patients born preterm that required admission at birth, it is possible that there was selection bias; however, we ought to note that all patients born before 34 weeks’ gestation or with low birth weight were admitted to the unit.Conflicts of interestThe authors have no conflicts of interest to declare" "textoCompletoSecciones" => array:1 [ "secciones" => array:12 [ 0 => array:3 [ "identificador" => "xres1226747" "titulo" => "Abstract" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Introduction" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec1140314" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres1226748" "titulo" => "Resumen" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Introducción" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusiones" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec1140313" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Methods" ] 6 => array:2 [ "identificador" => "sec0015" "titulo" => "Definitions" ] 7 => array:2 [ "identificador" => "sec0020" "titulo" => "Statistical analysis" ] 8 => array:2 [ "identificador" => "sec0025" "titulo" => "Results" ] 9 => array:2 [ "identificador" => "sec0030" "titulo" => "Discussion" ] 10 => array:2 [ "identificador" => "sec0035" "titulo" => "Conflicts of interest" ] 11 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2018-08-01" "fechaAceptado" => "2018-11-21" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1140314" "palabras" => array:4 [ 0 => "Neonatal mortality" 1 => "Neonatal sepsis" 2 => "Neonatal respiratory distress syndrome" 3 => "Cerebral intraventricular haemorrhage" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec1140313" "palabras" => array:4 [ 0 => "Mortalidad neonatal" 1 => "Sepsis neonatal" 2 => "Síndrome de distrés respiratorio neonatal" 3 => "Hemorragia intraventricular cerebral" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "IntroductionPrenatal corticosteroids reduce neonatal mortality and morbidity; however, there are few studies in developing countries, and with inconsistent results. The purpose of this study was to quantify the frequency of the use of prenatal corticosteroids and to estimate its effect on the morbidity and mortality of premature newborns. MethodsA retrospective cohort study was performed on premature newborns selected from a census conducted between January 2016 and August 2017. The use of corticosteroids was taken from the maternal records, and the dependent variables from the neonatal records. An analysis was made of the relationship using logistic regression, adjusted to gestational age and weight. ResultsThe study included 1083 premature infants of which 53.3% were male. The mean gestational age was 33.4 weeks. Corticosteroids were received by 42%, with latency ≥24h in 23.6% and ≥48h in 13.8%. Respiratory distress syndrome was observed in 35% (379/1083), early neonatal sepsis in 4.4% (48/1083), late neonatal sepsis in 10.7% (116/1083), intraventricular haemorrhage in 15.1% (137/908), chronic lung disease in 51.4% (165/321), and death in 22.3% (242/1083). Prenatal corticosteroids decreased the risk of death in children under 34 weeks (OR 0.63, 95% CI 0.40–0.98). The decrease was greater if they presented with latency ≥48h (OR 0.40, 95% CI 0.20–0.80). The rest of the dependent variables were not modified by the intervention. ConclusionsIn preterm infants, 42% received antenatal corticosteroids. In those with less than 34 weeks, there was a decrease in the risk of death without changes in morbidity." "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Introduction" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "IntroducciónLos corticosteroides prenatales disminuyen la morbimortalidad neonatal, sin embargo, existen pocos estudios en países en vías de desarrollo, con resultados no consistentes. El objetivo fue cuantificar la frecuencia del uso de corticosteroides prenatales y estimar su efecto en la morbimortalidad de recién nacidos prematuros. MétodosEstudio de cohorte retrospectivo; se seleccionaron los recién nacidos prematuros de un censo realizado entre enero de 2016 y agosto de 2017. De los expedientes maternos se registró el uso de corticosteroides; y de los expedientes de los neonatos se indagó las variables dependientes. La asociación se analizó con regresión logística, ajustada a la edad gestacional y el peso. ResultadosSe estudiaron 1.083 prematuros, el 53,3% de género masculino; la edad gestacional promedio fue 33,4 semanas. Recibieron corticosteroides el 42%, con latencia ≥24horas el 23,6% y ≥48horas el 13,8%. Presentaron síndrome de dificultad respiratoria el 35% (379/1083), sepsis neonatal temprana el 4,4% (48/1083), sepsis neonatal tardía el 10,7% (116/1083), hemorragia intraventricular el 15,1% (137/908), enfermedad pulmonar crónica el 51,4% (165/321) y muerte el 22,3% (242/1083). Los corticosteroides prenatales disminuyeron el riesgo de muerte en menores de 34 semanas (OR: 0,63, IC 95%: 0,40-0,98); el decremento fue mayor si presentaron latencia ≥48horas (OR: 0,40; IC 95%: 0,20-0,80). El resto de variables dependientes no se modificó por la intervención. ConclusionesEl 42% de los prematuros recibe corticosteroides prenatales. En menores de 34 semanas se observó una disminución del riesgo de muerte sin modificación en la morbilidad." "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Introducción" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusiones" ] ] ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "Please cite this article as: Pérez-Ramírez RO, Lona-Reyes JC, Ochoa-Meza CA, Gómez-Ruiz LM, Ramos-Gutiérrez RY, Camarena-Pulido EE, et al. Morbimortalidad neonatal en un entorno de baja adherencia a corticosteroides prenatales. An Pediatr (Barc). 2019;91:105–111." ] ] "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" => 2374 "Ancho" => 2945 "Tamanyo" => 232086 ] ] "descripcion" => array:1 [ "en" => "Survival of hospitalised preterm newborns by administration of antenatal corticosteroids, with a latency period of 48 or more hours, and in the subset of newborns born before 34 weeks’ gestation. Survival of hospitalised preterm newborns (n=1083). Preterm newborns exposed to corticosteroids vs not exposed (n=1083), P=.30 (log rank). Preterm newborns treated with corticosteroids with a latency period ≥48h vs not treated with corticosteroids (n=778), P=.34 (log-rank test). Preterm newborns born before 34 weeks that received corticosteroids with a latency period ≥48h vs preterm newborns <34 weeks not treated with corticosteroids (n=310), P=.009 (log-rank test)." ] ] 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: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="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Corticosteroidsn=455 \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">No corticosteroidsn=628 \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">P \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Weight (g, mean)<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1599.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1884.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Gestational age (weeks, mean)<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">32.66 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">33.87 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5-Minute Apgar score (mean)<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8.03 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7.86 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">.11 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Male sex (%)<a class="elsevierStyleCrossRef" href="#tblfn0010">b</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">53.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">52.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">.33 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Caesarean delivery (%)<a class="elsevierStyleCrossRef" href="#tblfn0010">b</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">77.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">65.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Maternal risk factors<a class="elsevierStyleCrossRef" href="#tblfn0010">b</a>,<a class="elsevierStyleCrossRef" href="#tblfn0015">c</a> (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">41.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">15.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2096126.png" ] ] ] "notaPie" => array:3 [ 0 => array:3 [ "identificador" => "tblfn0005" "etiqueta" => "a" "nota" => "Student t test." ] 1 => array:3 [ "identificador" => "tblfn0010" "etiqueta" => "b" "nota" => "Chi square test." ] 2 => array:3 [ "identificador" => "tblfn0015" "etiqueta" => "c" "nota" => "Maternal risk factors for infection: urinary tract infection, chorioamnionitis, premature rupture of membranes or fever during labour." ] ] ] "descripcion" => array:1 [ "en" => "Clinical and demographic characteristics of hospitalised preterm newborns based on the prenatal administration of corticosteroids." ] ] 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: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="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Prenatal corticosteroidsn=455 \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">No corticosteroidsn=628 \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">P<a class="elsevierStyleCrossRef" href="#tblfn0020">a</a> \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Respiratory distress syndrome (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">43.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">28.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Early-onset neonatal sepsis (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">.15 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Late-onset neonatal sepsis (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">.21 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Intraventricular haemorrhage (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">17.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">.04 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Bronchopulmonary dysplasia (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">24.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">15.2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Death (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">25.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">20.2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">.04 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2096128.png" ] ] ] "notaPie" => array:1 [ 0 => array:3 [ "identificador" => "tblfn0020" "etiqueta" => "a" "nota" => "Chi square test." ] ] ] "descripcion" => array:1 [ "en" => "Morbidity and mortality in hospitalised preterm newborns based on the use of prenatal corticosteroids." ] ] 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: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="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Total samplen=1083OR (95% CI) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Gestational age <34 weeksn=505OR (95% CI) \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Respiratory distress syndrome \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.16 (0.85–1.57) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.25 (0.84–1.87) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Early-onset neonatal sepsis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.53 (0.84–2.77) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.05 (0.44–2.48) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Late-onset neonatal sepsis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.09 (0.73–1.62) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.08 (0.66–1.77) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Intraventricular haemorrhage<a class="elsevierStyleCrossRef" href="#tblfn0025">a</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.81 (0.53–1.23) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.76 (0.47–1.25) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Bronchopulmonary dysplasia<a class="elsevierStyleCrossRef" href="#tblfn0030">b</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.94 (0.59–1.50) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.02 (0.59–1.80) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Death \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.73 (0.52–1.04) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.63 (0.40–0.98) \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2096129.png" ] ] ] "notaPie" => array:2 [ 0 => array:3 [ "identificador" => "tblfn0025" "etiqueta" => "a" "nota" => "Only includes patients that underwent a transfontanellar ultrasound scan (n=908/n=431)." ] 1 => array:3 [ "identificador" => "tblfn0030" "etiqueta" => "b" "nota" => "Only includes patients aged more than 28 days (n=321/n=226)." ] ] ] "descripcion" => array:1 [ "en" => "Morbidity and mortality in hospitalised preterm newborns and in the subgroup of newborns delivered before 34 weeks’ gestation by use of prenatal corticosteroids (adjusted for gestational age and birth weight using logistic regression)." ] ] 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="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Total samplen=778<a class="elsevierStyleCrossRef" href="#tblfn0035">a</a>OR (95% CI) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Gestational age <34 weeksn=310<a class="elsevierStyleCrossRef" href="#tblfn0035">a</a>OR (95% CI) \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Respiratory distress syndrome \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.89 (0.57–1.40) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.87 (0.48–1.57) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Early-onset neonatal sepsis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.75 (0.78–3.92) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.61 (0.13–2.87) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Late-onset neonatal sepsis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.41 (0.83–2.40) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.62 (0.84–3.12) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Intraventricular haemorrhage<a class="elsevierStyleCrossRef" href="#tblfn0040">b</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.66 (0.35–1.24) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.65 (0.31–1.37) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Bronchopulmonary dysplasia<a class="elsevierStyleCrossRef" href="#tblfn0045">c</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.0 (0.53–1.91) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.19 (0.56–2.54) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Death \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.59 (0.35–1.03) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.40 (0.20–0.80)<a class="elsevierStyleCrossRef" href="#tblfn0035">a</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2096127.png" ] ] ] "notaPie" => array:3 [ 0 => array:3 [ "identificador" => "tblfn0035" "etiqueta" => "a" "nota" => "Comparison of patients exposed to corticosteroids with a latency period of ≥ 48 h vs patients not exposed to corticosteroids." ] 1 => array:3 [ "identificador" => "tblfn0040" "etiqueta" => "b" "nota" => "Only includes patients that underwent a transfontanellar ultrasound scan (n=642/n=258)." ] 2 => array:3 [ "identificador" => "tblfn0045" "etiqueta" => "c" "nota" => "Only includes patients aged more than 28 days (n=216/n=142)." ] ] ] "descripcion" => array:1 [ "en" => "Morbidity and mortality in hospitalised preterm newborns and in the subgroup of newborns delivered before 34 weeks’ gestation by use of prenatal corticosteroids with a latency period of ≥48h (adjusted for gestational age and birth weight using logistic regression)." ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:27 [ 0 => array:3 [ "identificador" => "bib0140" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Neonatal mortality levels for 193 countries in 2009 with trends since 1990: a systematic analysis of progress, projections, and priorities" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M.Z. Oestergaard" 1 => "M. Inoue" 2 => "S. Yoshida" 3 => "W.R. Mahanani" 4 => "F.M. Gore" 5 => "S. Cousens" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1371/journal.pmed.1001080" "Revista" => array:5 [ "tituloSerie" => "PLoS Med" "fecha" => "2011" "volumen" => "8" "paginaInicial" => "e1001080" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21918640" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0145" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Levels and causes of mortality under age five years" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "L. Liu" 1 => "K. Hill" 2 => "S. Oza" 3 => "D. Hogan" 4 => "Y. Chu" 5 => "S. Cousens" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:6 [ "paginaInicial" => "71" "paginaFinal" => "83" "edicion" => "3rd ed." "serieVolumen" => "vol. 2" "serieTitulo" => "Reproductive, maternal, newborn, and child health. Disease control priorities" "serieFecha" => "2016" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0150" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Interventions to reduce maternal and newborn morbidity and mortality" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A.M. Gülmezoglu" 1 => "T.A. Lawrie" 2 => "N. Hezelgrave" 3 => "O.T. Oladapo" 4 => "J.P. Souza" 5 => "M. Gielen" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:6 [ "paginaInicial" => "115" "paginaFinal" => "136" "edicion" => "3rd ed." "serieVolumen" => "vol. 2" "serieTitulo" => "Reproductive, maternal, newborn, and child health. Disease control priorities" "serieFecha" => "2016" ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0155" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A controlled trial of antepartum glucocorticoid treatment for prevention of the respiratory distress syndrome in premature infants" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "G.C. Liggins" 1 => "R.N. Howie" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Pediatrics" "fecha" => "1972" "volumen" => "50" "paginaInicial" => "515" "paginaFinal" => "525" ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0160" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Antenatal corticosteroids at the beginning of the 21st century" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "C.A. Riley" 1 => "K. Boozer" 2 => "T.L. King" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1542-2011.2011.00119.x" "Revista" => array:6 [ "tituloSerie" => "J Midwifery Womens Health" "fecha" => "2011" "volumen" => "56" "paginaInicial" => "591" "paginaFinal" => "597" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22060219" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0165" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Antenatal steroids: can we optimize the dose?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "E. Romejko-Wolniewicz" 1 => "J. Teliga-Czajkowska" 2 => "K. Czajkowski" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/GCO.0000000000000047" "Revista" => array:6 [ "tituloSerie" => "Curr Opin Obstet Gynecol" "fecha" => "2014" "volumen" => "26" "paginaInicial" => "77" "paginaFinal" => "82" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24463225" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0170" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Corticoterapia prenatal y morbimortalidad del prematuro tardío: estudio prospectivo" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "I.M. Gázquez Serrano" 1 => "A. Arroyos Plana" 2 => "O. Díaz Morales" 3 => "C. Herráiz Perea" 4 => "C.A. Holgueras Bragado" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "An Pediatr" "fecha" => "2014" "volumen" => "81" "paginaInicial" => "374" "paginaFinal" => "382" ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0175" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Antenatal betamethasone for women at risk for late preterm delivery" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "C. Gyamfi-Bannerman" 1 => "E.A. Thom" 2 => "S.C. Blackwell" 3 => "A.T. Tita" 4 => "U.M. Reddy" 5 => "G.R. Saade" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1056/NEJMoa1516783" "Revista" => array:6 [ "tituloSerie" => "N Engl J Med" "fecha" => "2016" "volumen" => "374" "paginaInicial" => "1311" "paginaFinal" => "1320" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26842679" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0180" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Antenatal corticosteroids for accelerating fetal lung maturation for women at risk of preterm birth" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "D. Roberts" 1 => "J. Brown" 2 => "N. Medley" 3 => "S.R. Dalziel" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:3 [ "tituloSerie" => "Cochrane Database Syst Rev" "fecha" => "2017" "volumen" => "3" ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0185" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Association of antenatal corticosteroids and the mode of delivery with the mortality and morbidity of infants weighing less than 1,500g at birth in Japan" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "Y. Sasaki" 1 => "T. Ikeda" 2 => "K. Nishimura" 3 => "S. Katsuragi" 4 => "K. Sengoku" 5 => "S. Kusuda" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1159/000358189" "Revista" => array:6 [ "tituloSerie" => "Neonatology" "fecha" => "2014" "volumen" => "106" "paginaInicial" => "81" "paginaFinal" => "86" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24819396" "web" => "Medline" ] ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0190" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Antenatal corticosteroids for reducing adverse maternal and child outcomes in special populations of women at risk of imminent preterm birth: a systematic review and meta-analysis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "R.M. Amiya" 1 => "L.B. Mlunde" 2 => "E. Ota" 3 => "T. Swa" 4 => "O.T. Oladapo" 5 => "R. Mori" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:4 [ "tituloSerie" => "PLOS ONE" "fecha" => "2016" "volumen" => "11" "paginaInicial" => "e0147604" ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0195" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Association of antenatal corticosteroids with mortality and neurodevelopmental outcomes among infants born at 22 to 25 weeks’ gestation" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "W.A. Carlo" 1 => "S.A. McDonald" 2 => "A.A. Fanaroff" 3 => "B.R. Vohr" 4 => "B.J. Stoll" 5 => "R.A. Ehrenkranz" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1001/jama.2011.1752" "Revista" => array:6 [ "tituloSerie" => "JAMA" "fecha" => "2011" "volumen" => "306" "paginaInicial" => "2348" "paginaFinal" => "2358" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22147379" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0200" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Antenatal corticosteroids for women at risk of imminent preterm birth in low-resource countries: the case for equipoise and the need for efficacy trials" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J.P. Vogel" 1 => "O.T. Oladapo" 2 => "C. Pileggi-Castro" 3 => "E.A. Adejuyigbe" 4 => "F. Althabe" 5 => "S. Ariff" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1136/bmjgh-2017-000398" "Revista" => array:5 [ "tituloSerie" => "BMJ Glob Health" "fecha" => "2017" "volumen" => "2" "paginaInicial" => "e000398" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29082019" "web" => "Medline" ] ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0205" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Committee Opinion No. 713: antenatal corticosteroid therapy for fetal maturation" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "Committee on Obstetric Practice" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/AOG.0000000000002237" "Revista" => array:6 [ "tituloSerie" => "Obstet Gynecol" "fecha" => "2017" "volumen" => "130" "paginaInicial" => "e102" "paginaFinal" => "e109" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28742678" "web" => "Medline" ] ] ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0210" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Different corticosteroids and regimens for accelerating fetal lung maturation for women at risk of preterm birth" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "F.C. Brownfoot" 1 => "D.I. Gagliardi" 2 => "E. Bain" 3 => "P. Middleton" 4 => "C.A. Crowther" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:2 [ "tituloSerie" => "Cochrane Database Syst Rev" "fecha" => "2013" ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib0215" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "No. 364-Antenatal corticosteroid therapy for improving neonatal outcomes" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. Skoll" 1 => "A. Boutin" 2 => "E. Bujold" 3 => "J. Burrows" 4 => "J. Crane" 5 => "M. Geary" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jogc.2018.04.018" "Revista" => array:6 [ "tituloSerie" => "J Obstet Gynaecol Can" "fecha" => "2018" "volumen" => "40" "paginaInicial" => "1219" "paginaFinal" => "1239" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30268316" "web" => "Medline" ] ] ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib0220" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Antenatal corticosteroid therapy for reduction of neonatal morbidity and mortality from preterm delivery" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "M.J. Lee" 1 => "D. Guinn" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:3 [ "editores" => "C.J.Lockwood, R.Martin" "titulo" => "UpToDate" "serieFecha" => "2017" ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib0225" "etiqueta" => "18" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Neonatal mortality and associated factors in newborn infants admitted to a neonatal care unit" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "J.C. Lona Reyes" 1 => "R.O. Pérez Ramírez" 2 => "L. Llamas Ramos" 3 => "L.M. Gómez Ruiz" 4 => "E.A. Benítez Vázquez" 5 => "V. Rodríguez Patino" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.5546/aap.2018.eng.42" "Revista" => array:6 [ "tituloSerie" => "Arch Argent Pediatr" "fecha" => "2018" "volumen" => "116" "paginaInicial" => "42" "paginaFinal" => "48" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29333811" "web" => "Medline" ] ] ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib0230" "etiqueta" => "19" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Diagnóstico y manejo del parto pretérmino (documento en línea; 37 páginas en pantalla)" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "Consejo de Salubridad General" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:3 [ "fecha" => "2009" "editorial" => "Secretaría de Salud" "editorialLocalizacion" => "México" ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib0235" "etiqueta" => "20" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Born too soon preterm birth action group born too soon: preterm birth matters" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "C.P. Howson" 1 => "M.V. Kinney" 2 => "L. McDougall" 3 => "J.E. Lawn" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1186/1742-4755-10-S1-S1" "Revista" => array:6 [ "tituloSerie" => "Reprod Health" "fecha" => "2013" "volumen" => "10" "numero" => "Suppl. 1" "paginaInicial" => "S1" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24625113" "web" => "Medline" ] ] ] ] ] ] ] ] 20 => array:3 [ "identificador" => "bib0240" "etiqueta" => "21" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Población. Natalidad y fecundidad" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "Instituto Nacional de Estadística y Geografía" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:3 [ "fecha" => "2018" "editorial" => "INEGI" "editorialLocalizacion" => "México" ] ] ] ] ] ] 21 => array:3 [ "identificador" => "bib0245" "etiqueta" => "22" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Use of antenatal corticosteroids at health facilities and communities in low- and-middle income countries" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M. Berrueta" 1 => "J. Hemingway-Foday" 2 => "V.R. Thorsten" 3 => "R.L. Goldenberg" 4 => "W.A. Carlo" 5 => "A. Garces" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1186/s12978-016-0176-2" "Revista" => array:5 [ "tituloSerie" => "Reprod Health" "fecha" => "2016" "volumen" => "13" "paginaInicial" => "66" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27228986" "web" => "Medline" ] ] ] ] ] ] ] ] 22 => array:3 [ "identificador" => "bib0250" "etiqueta" => "23" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Use of antenatal corticosteroids for preterm birth in Latin America: providers knowledge, attitudes and practices" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. Aleman" 1 => "M.L. Cafferata" 2 => "L. Gibbons" 3 => "F. Althabe" 4 => "J. Ortiz" 5 => "X. Sandoval" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1186/1742-4755-10-4" "Revista" => array:5 [ "tituloSerie" => "Reprod Health" "fecha" => "2013" "volumen" => "10" "paginaInicial" => "4" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23360713" "web" => "Medline" ] ] ] ] ] ] ] ] 23 => array:3 [ "identificador" => "bib0255" "etiqueta" => "24" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Association between antenatal corticosteroid administration-to-birth interval and outcomes of preterm neonates" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "N. Melamed" 1 => "J. Shah" 2 => "A. Soraisham" 3 => "E.W. Yoon" 4 => "S.K. Lee" 5 => "P.S. Shah" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Obstet Gynecol" "fecha" => "2015" "volumen" => "125" "paginaInicial" => "1377" "paginaFinal" => "1384" ] ] ] ] ] ] 24 => array:3 [ "identificador" => "bib0260" "etiqueta" => "25" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Association of short antenatal corticosteroid administration-to-birth intervals with survival and morbidity among very preterm infants: results from the EPICE Cohort" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "M. Norman" 1 => "A. Piedvache" 2 => "K. Børch" 3 => "L.D. Huusom" 4 => "A.E. Bonamy" 5 => "E.A. Howell" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1001/jamapediatrics.2017.0602" "Revista" => array:6 [ "tituloSerie" => "JAMA Pediatr" "fecha" => "2017" "volumen" => "171" "paginaInicial" => "678" "paginaFinal" => "686" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28505223" "web" => "Medline" ] ] ] ] ] ] ] ] 25 => array:3 [ "identificador" => "bib0265" "etiqueta" => "26" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A population-based, multifaceted strategy to implement antenatal corticosteroid treatment versus standard care for the reduction of neonatal mortality due to preterm birth in low-income and middle-income countries: the ACT cluster-randomised trial" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "F. Althabe" 1 => "J.M. Belizán" 2 => "E.M. McClure" 3 => "J. Hemingway-Foday" 4 => "M. Berrueta" 5 => "A. Mazzoni" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/S0140-6736(14)61651-2" "Revista" => array:6 [ "tituloSerie" => "Lancet" "fecha" => "2015" "volumen" => "385" "paginaInicial" => "629" "paginaFinal" => "639" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25458726" "web" => "Medline" ] ] ] ] ] ] ] ] 26 => array:3 [ "identificador" => "bib0270" "etiqueta" => "27" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The Antenatal Corticosteroids Trial (ACT)’s explanations for neonatal mortality – a secondary analysis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "F. Althabe" 1 => "V. Thorsten" 2 => "K. Klein" 3 => "E.M. McClure" 4 => "P.L. Hibberd" 5 => "R.L. Goldenberg" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1186/s12978-016-0175-3" "Revista" => array:5 [ "tituloSerie" => "Reprod Health" "fecha" => "2016" "volumen" => "13" "paginaInicial" => "62" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27220987" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/23412879/0000009100000002/v1_201908020803/S2341287919301115/v1_201908020803/en/main.assets" "Apartado" => array:4 [ "identificador" => "26005" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Original Articles" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/23412879/0000009100000002/v1_201908020803/S2341287919301115/v1_201908020803/en/main.pdf?idApp=UINPBA00005H&text.app=https://analesdepediatria.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341287919301115?idApp=UINPBA00005H"]

Statistics

Original Article

Neonatal morbidity and mortality associated with low adherence to prenatal corticosteroids

Morbimortalidad neonatal en un entorno de baja adherencia a corticosteroides prenatales

Rene O. Pérez-Ramíreza, Juan Carlos Lona-Reyesa,b,

Corresponding author

carloslona5@hotmail.com

Corresponding author.

, Cesar A. Ochoa-Mezaa, Larissa M. Gómez-Ruiza, Ruth Y. Ramos-Gutiérreza, E. Elizabeth Camarena-Pulidoa, J. Antonio Gallegos-Marínb

a Hospital Civil de Guadalajara Dr. Juan I. Menchaca, División de Pediatría, Guadalajara, Jalisco, Mexico

b Centro Universitario de Tonalá, Universidad de Guadalajara, Tonalá, Jalisco, Mexico

Read

4287

Times
was read the article

1606

Total PDF

2681

Total HTML

Share statistics

 array:24 [
  "pii" => "S2341287919301115"
  "issn" => "23412879"
  "doi" => "10.1016/j.anpede.2018.11.015"
  "estado" => "S300"
  "fechaPublicacion" => "2019-08-01"
  "aid" => "2560"
  "copyrightAnyo" => "2019"
  "documento" => "article"
  "crossmark" => 1
  "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
  "subdocumento" => "fla"
  "cita" => "An Pediatr &#40;Barc&#41;. 2019;91:105-11"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 512
    "formatos" => array:3 [
      "EPUB" => 58
      "HTML" => 357
      "PDF" => 97
    ]
  ]
  "Traduccion" => array:1 [
    "es" => array:20 [
      "pii" => "S1695403318305411"
      "issn" => "16954033"
      "doi" => "10.1016/j.anpedi.2018.11.011"
      "estado" => "S300"
      "fechaPublicacion" => "2019-08-01"
      "aid" => "2560"
      "copyright" => "Asociaci&#243;n Espa&#241;ola de Pediatr&#237;a"
      "documento" => "article"
      "crossmark" => 1
      "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
      "subdocumento" => "fla"
      "cita" => "An Pediatr &#40;Barc&#41;. 2019;91:105-11"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:2 [
        "total" => 1961
        "formatos" => array:3 [
          "EPUB" => 88
          "HTML" => 1416
          "PDF" => 457
        ]
      ]
      "es" => array:13 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Original</span>"
        "titulo" => "Morbimortalidad neonatal en un entorno de baja adherencia a corticosteroides prenatales"
        "tienePdf" => "es"
        "tieneTextoCompleto" => "es"
        "tieneResumen" => array:2 [
          0 => "es"
          1 => "en"
        ]
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "105"
            "paginaFinal" => "111"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "en" => array:1 [
            "titulo" => "Neonatal morbidity and mortality associated with low adherence to prenatal corticosteroids"
          ]
        ]
        "contieneResumen" => array:2 [
          "es" => true
          "en" => true
        ]
        "contieneTextoCompleto" => array:1 [
          "es" => true
        ]
        "contienePdf" => array:1 [
          "es" => true
        ]
        "resumenGrafico" => array:2 [
          "original" => 0
          "multimedia" => array:7 [
            "identificador" => "fig0005"
            "etiqueta" => "Figura 1"
            "tipo" => "MULTIMEDIAFIGURA"
            "mostrarFloat" => true
            "mostrarDisplay" => false
            "figura" => array:1 [
              0 => array:4 [
                "imagen" => "gr1.jpeg"
                "Alto" => 2386
                "Ancho" => 2925
                "Tamanyo" => 326613
              ]
            ]
            "descripcion" => array:1 [
              "es" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Supervivencia de reci&#233;n nacidos prematuros hospitalizados en funci&#243;n de la administraci&#243;n de corticosteroides prenatales&#44; con latencia &#8805;<span class="elsevierStyleHsp" style=""></span>48<span class="elsevierStyleHsp" style=""></span>horas&#44; y en subgrupo de pacientes<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>34 semanas&#46;</p> <p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Supervivencia de pacientes prematuros hospitalizados &#40;n<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleMonospace">&#61;</span><span class="elsevierStyleHsp" style=""></span>1&#46;083&#41;</p> <p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">RN prematuros con corticosteroides vs&#46; sin corticosteroides &#40;n<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleMonospace">&#61;</span><span class="elsevierStyleHsp" style=""></span>1&#46;083&#41; p<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleMonospace">&#61;</span><span class="elsevierStyleHsp" style=""></span>0&#44;30 &#40;Log Rank&#41;</p> <p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">RN prematuros con corticosteroides con latencia<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>48<span class="elsevierStyleHsp" style=""></span>h vs&#46; sin corticosteroides &#40;n<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleMonospace">&#61;</span><span class="elsevierStyleHsp" style=""></span>778&#41; p<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleMonospace">&#61;</span><span class="elsevierStyleHsp" style=""></span>0&#44;34 &#40;Log Rank&#41;</p> <p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">RN<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>34 semanas con corticosteroides con latencia<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>48<span class="elsevierStyleHsp" style=""></span>h vs&#46; RN<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>34 semanas sin corticosteroides &#40;n<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleMonospace">&#61;</span><span class="elsevierStyleHsp" style=""></span>310&#41; p<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleMonospace">&#61;</span><span class="elsevierStyleHsp" style=""></span>0&#44;009 &#40;Log Rank&#41;&#46;</p>"
            ]
          ]
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "Rene O&#46; P&#233;rez-Ram&#237;rez, Juan Carlos Lona-Reyes, Cesar A&#46; Ochoa-Meza, Larissa M&#46; G&#243;mez-Ruiz, Ruth Y&#46; Ramos-Guti&#233;rrez, E&#46; Elizabeth Camarena-Pulido, J&#46; Antonio Gallegos-Mar&#237;n"
            "autores" => array:7 [
              0 => array:2 [
                "nombre" => "Rene O&#46;"
                "apellidos" => "P&#233;rez-Ram&#237;rez"
              ]
              1 => array:2 [
                "nombre" => "Juan Carlos"
                "apellidos" => "Lona-Reyes"
              ]
              2 => array:2 [
                "nombre" => "Cesar A&#46;"
                "apellidos" => "Ochoa-Meza"
              ]
              3 => array:2 [
                "nombre" => "Larissa M&#46;"
                "apellidos" => "G&#243;mez-Ruiz"
              ]
              4 => array:2 [
                "nombre" => "Ruth Y&#46;"
                "apellidos" => "Ramos-Guti&#233;rrez"
              ]
              5 => array:2 [
                "nombre" => "E&#46; Elizabeth"
                "apellidos" => "Camarena-Pulido"
              ]
              6 => array:2 [
                "nombre" => "J&#46; Antonio"
                "apellidos" => "Gallegos-Mar&#237;n"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "es"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S2341287919301115"
          "doi" => "10.1016/j.anpede.2018.11.015"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => true
            "ES2" => true
            "LATM" => true
          ]
          "gratuito" => true
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "en"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341287919301115?idApp=UINPBA00005H"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1695403318305411?idApp=UINPBA00005H"
      "url" => "/16954033/0000009100000002/v1_201908020636/S1695403318305411/v1_201908020636/es/main.assets"
    ]
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S2341287919301061"
    "issn" => "23412879"
    "doi" => "10.1016/j.anpede.2018.11.013"
    "estado" => "S300"
    "fechaPublicacion" => "2019-08-01"
    "aid" => "2559"
    "documento" => "article"
    "crossmark" => 1
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "fla"
    "cita" => "An Pediatr &#40;Barc&#41;. 2019;91:112-9"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 1117
      "formatos" => array:3 [
        "EPUB" => 63
        "HTML" => 835
        "PDF" => 219
      ]
    ]
    "en" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original Article</span>"
      "titulo" => "What is the optimal flow on starting high-flow oxygen therapy for bronchiolitis treatment in paediatric wards&#63;"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "112"
          "paginaFinal" => "119"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "&#191;Cu&#225;l es el flujo inicial id&#243;neo en la oxigenoterapia de alto flujo para el tratamiento de la bronquiolitis en las plantas de hospitalizaci&#243;n&#63;"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0010"
          "etiqueta" => "Figure 2"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr2.jpeg"
              "Alto" => 1913
              "Ancho" => 2826
              "Tamanyo" => 194444
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Changes in the heart rate and respiratory rate severity parameters by initial flow rate&#46;</p> <p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">HFNC&#44; high-flow oxygen therapy with nasal cannula&#59; HR&#44; heart rate&#59; RR&#44; respiratory rate&#46; &#42;Statistically significant&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Felipe Gonz&#225;lez Mart&#237;nez, Mar&#237;a Isabel Gonz&#225;lez S&#225;nchez, Jimena P&#233;rez-Moreno, Blanca Toledo del Castillo, Rosa Rodr&#237;guez Fern&#225;ndez"
          "autores" => array:5 [
            0 => array:2 [
              "nombre" => "Felipe"
              "apellidos" => "Gonz&#225;lez Mart&#237;nez"
            ]
            1 => array:2 [
              "nombre" => "Mar&#237;a Isabel"
              "apellidos" => "Gonz&#225;lez S&#225;nchez"
            ]
            2 => array:2 [
              "nombre" => "Jimena"
              "apellidos" => "P&#233;rez-Moreno"
            ]
            3 => array:2 [
              "nombre" => "Blanca"
              "apellidos" => "Toledo del Castillo"
            ]
            4 => array:2 [
              "nombre" => "Rosa"
              "apellidos" => "Rodr&#237;guez Fern&#225;ndez"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S169540331830540X"
        "doi" => "10.1016/j.anpedi.2018.11.010"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "es"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S169540331830540X?idApp=UINPBA00005H"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341287919301061?idApp=UINPBA00005H"
    "url" => "/23412879/0000009100000002/v1_201908020803/S2341287919301061/v1_201908020803/en/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S2341287919301073"
    "issn" => "23412879"
    "doi" => "10.1016/j.anpede.2018.11.014"
    "estado" => "S300"
    "fechaPublicacion" => "2019-08-01"
    "aid" => "2561"
    "documento" => "article"
    "crossmark" => 1
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "fla"
    "cita" => "An Pediatr &#40;Barc&#41;. 2019;91:96-104"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 437
      "formatos" => array:3 [
        "EPUB" => 44
        "HTML" => 292
        "PDF" => 101
      ]
    ]
    "en" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original Article</span>"
      "titulo" => "Factors associated with the prevalence of hypovitaminosis D in pregnant women and their newborns"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "96"
          "paginaFinal" => "104"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Factores asociados a la prevalencia de hipovitaminosis D en mujeres embarazadas y sus reci&#233;n nacidos"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0005"
          "etiqueta" => "Figure 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 1767
              "Ancho" => 2673
              "Tamanyo" => 130432
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Mean vitamin D levels in maternal blood and umbilical cord blood by month of delivery&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Elizabeth Blarduni, Arantzazu Arrospide, Mar Galar, Luis Casta&#241;o, Javier Mar"
          "autores" => array:6 [
            0 => array:2 [
              "nombre" => "Elizabeth"
              "apellidos" => "Blarduni"
            ]
            1 => array:2 [
              "nombre" => "Arantzazu"
              "apellidos" => "Arrospide"
            ]
            2 => array:2 [
              "nombre" => "Mar"
              "apellidos" => "Galar"
            ]
            3 => array:2 [
              "nombre" => "Luis"
              "apellidos" => "Casta&#241;o"
            ]
            4 => array:2 [
              "nombre" => "Javier"
              "apellidos" => "Mar"
            ]
            5 => array:1 [
              "colaborador" => "GOIVIDE Group"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S1695403318305423"
        "doi" => "10.1016/j.anpedi.2018.11.012"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "es"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1695403318305423?idApp=UINPBA00005H"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341287919301073?idApp=UINPBA00005H"
    "url" => "/23412879/0000009100000002/v1_201908020803/S2341287919301073/v1_201908020803/en/main.assets"
  ]
  "en" => array:20 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Original Article</span>"
    "titulo" => "Neonatal morbidity and mortality associated with low adherence to prenatal corticosteroids"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "105"
        "paginaFinal" => "111"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "Rene O&#46; P&#233;rez-Ram&#237;rez, Juan Carlos Lona-Reyes, Cesar A&#46; Ochoa-Meza, Larissa M&#46; G&#243;mez-Ruiz, Ruth Y&#46; Ramos-Guti&#233;rrez, E&#46; Elizabeth Camarena-Pulido, J&#46; Antonio Gallegos-Mar&#237;n"
        "autores" => array:7 [
          0 => array:3 [
            "nombre" => "Rene O&#46;"
            "apellidos" => "P&#233;rez-Ram&#237;rez"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          1 => array:4 [
            "nombre" => "Juan Carlos"
            "apellidos" => "Lona-Reyes"
            "email" => array:1 [
              0 => "carloslona5@hotmail.com"
            ]
            "referencia" => array:3 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
              2 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "Cesar A&#46;"
            "apellidos" => "Ochoa-Meza"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          3 => array:3 [
            "nombre" => "Larissa M&#46;"
            "apellidos" => "G&#243;mez-Ruiz"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          4 => array:3 [
            "nombre" => "Ruth Y&#46;"
            "apellidos" => "Ramos-Guti&#233;rrez"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          5 => array:3 [
            "nombre" => "E&#46; Elizabeth"
            "apellidos" => "Camarena-Pulido"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          6 => array:3 [
            "nombre" => "J&#46; Antonio"
            "apellidos" => "Gallegos-Mar&#237;n"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:2 [
          0 => array:3 [
            "entidad" => "Hospital Civil de Guadalajara Dr&#46; Juan I&#46; Menchaca&#44; Divisi&#243;n de Pediatr&#237;a&#44; Guadalajara&#44; Jalisco&#44; Mexico"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Centro Universitario de Tonal&#225;&#44; Universidad de Guadalajara&#44; Tonal&#225;&#44; Jalisco&#44; Mexico"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Morbimortalidad neonatal en un entorno de baja adherencia a corticosteroides prenatales"
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 2374
            "Ancho" => 2945
            "Tamanyo" => 232086
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Survival of hospitalised preterm newborns by administration of antenatal corticosteroids&#44; with a latency period of 48 or more hours&#44; and in the subset of newborns born before 34 weeks&#8217; gestation&#46;</p> <p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Survival of hospitalised preterm newborns &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1083&#41;&#46;</p> <p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Preterm newborns exposed to corticosteroids vs not exposed &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1083&#41;&#44; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;30 &#40;log rank&#41;&#46;</p> <p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Preterm newborns treated with corticosteroids with a latency period &#8805;48<span class="elsevierStyleHsp" style=""></span>h vs not treated with corticosteroids &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>778&#41;&#44; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;34 &#40;log-rank test&#41;&#46;</p> <p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Preterm newborns born before 34 weeks that received corticosteroids with a latency period &#8805;48<span class="elsevierStyleHsp" style=""></span>h vs preterm newborns &#60;34 weeks not treated with corticosteroids &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>310&#41;&#44; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;009 &#40;log-rank test&#41;&#46;</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">In recent decades&#44; the risk of death during the neonatal period has decreased by 28&#37; worldwide from 33&#46;2 to 23&#46;9 deaths per 1000 live births&#44;<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">1</span></a> although the number of deaths continues to be higher in low-income countries&#46;<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">2</span></a> One of the interventions proposed for performance during labour with the aim of reducing neonatal mortality is administration of antenatal corticosteroids&#46;<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">3</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">The administration of corticosteroids is mainly recommended in women at risk of preterm birth before 34 weeks&#8217; gestation&#44;<a class="elsevierStyleCrossRefs" href="#bib0155"><span class="elsevierStyleSup">4&#8211;6</span></a> but beneficial effects have been described even in late-preterm newborns&#46;<a class="elsevierStyleCrossRefs" href="#bib0170"><span class="elsevierStyleSup">7&#44;8</span></a> There is evidence that their administration significantly reduces the risk of perinatal death&#44; respiratory distress syndrome &#40;RDS&#41;&#44; intraventricular haemorrhage &#40;IVH&#41;&#44; necrotising enterocolitis&#44; retinopathy of prematurity&#44; systemic infection&#44;<a class="elsevierStyleCrossRefs" href="#bib0180"><span class="elsevierStyleSup">9&#8211;11</span></a> neurodevelopmental abnormalities and cerebral palsy&#44;<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">12</span></a> but most studies have been conducted in first world countries&#44; so the outcomes in developing countries could be different&#46;<a class="elsevierStyleCrossRefs" href="#bib0180"><span class="elsevierStyleSup">9&#44;13</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">The corticosteroids that cross the placental barrier and may be used for this purpose are betamethasone and dexamethasone&#46;<a class="elsevierStyleCrossRefs" href="#bib0160"><span class="elsevierStyleSup">5&#44;14&#8211;16</span></a> Their effect peaks 24&#8211;48<span class="elsevierStyleHsp" style=""></span>h after administration&#44;<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">6</span></a> but some authors have described the use of incomplete courses or schemes with a short interval between doses with inconsistent results&#46;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">17</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">The aim of our study was to measure the frequency of the use of antenatal corticosteroids and estimate their effect on the morbidity and mortality of preterm newborns in a neonatal care unit in western Mexico&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Methods</span><p id="par0025" class="elsevierStylePara elsevierViewall">We conducted a retrospective cohort study at the Hospital Civil de Guadalajara Dr&#46; Juan I&#46; Menchaca &#40;HCGJIM&#41; in the city of Guadalajara in Jalisco&#44; Mexico&#46; Our hospital provides health care services to the uninsured and low-income population&#46; The department of obstetrics includes the labour and delivery unit &#40;12 beds&#44; 3 operating rooms and 3 delivery rooms&#41; and the inpatient unit &#40;91 beds&#41;&#59; the department of neonatology includes 18 neonatal intensive care beds and 57 intermediate care beds&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">We selected patients from the cohort of patients documented in the records between January 25&#44; 2016 and August 31&#44; 2017&#44; which include information on the demographic and clinical characteristics&#44; morbidity and mortality of all children born in the hospital &#40;date of birth&#44; sex&#44; gestational age&#44; 5-minute Apgar score&#44; mode of delivery&#44; use of antenatal corticosteroids&#44; death during hospitalisation&#44; cause of death&#44; maternal risk factors for neonatal infection and maternal age&#41;&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">From this study universe&#44; we selected the newborns delivered before 37 weeks&#8217; gestation that were admitted to the neonatal unit after birth&#44; excluding newborns transferred from other units in the hospital or born outside the period under study&#46; We calculated the sample size needed to identify an OR of 0&#46;5&#44;<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">9</span></a> assuming the known proportion of death in hospitalised newborns in our hospital of 12&#46;5&#37;&#44;<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">18</span></a> for an alfa of 0&#46;05 and a power of 0&#46;80&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">We made a retrospective review of maternal records to obtain data on the prescription and administration of antenatal corticosteroids &#40;type of corticosteroids&#44; dosage&#44; number of doses and latency period&#59; latency period was defined as the number of hours elapsed from administration to the first dose of corticosteroids to the time of delivery&#41;&#46; The drugs were prescribed by the gynaecologists-obstetricians of the hospital in compliance with the clinical practice guidelines of the Secretariat of Health &#40;betamethasone or dexamethasone&#44; 2 intramuscular 12<span class="elsevierStyleHsp" style=""></span>mg doses given 12&#8211;24<span class="elsevierStyleHsp" style=""></span>h apart&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">19</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">We reviewed the health records of the newborns to find out whether they presented any of the following during hospitalisation&#58; RDS&#44; IVH&#44; early-onset neonatal sepsis &#40;EONS&#41;&#44; late-onset neonatal sepsis &#40;LONS&#41; and chronic lung disease &#40;CLD&#41;&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Definitions</span><p id="par0050" class="elsevierStylePara elsevierViewall">We obtained information on RDS&#44; IVH&#44; EONS&#44; LONS and CLD from the patient health records&#46; The physicians in charge of the patient made the diagnoses according to the following definitions&#58;<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">-</span><p id="par0055" class="elsevierStylePara elsevierViewall">Respiratory distress syndrome&#58; progressive breathing difficulty from the first minutes of life with increasing oxygen requirements and radiologic findings associated with increased alveolar surface tension&#46;</p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">-</span><p id="par0060" class="elsevierStylePara elsevierViewall">Intraventricular haemorrhage&#58; bleeding confined to the cerebral ventricles&#44; diagnosis made by ultrasound scan performed by a radiologist and severity graded according to the Papile classification&#46;</p></li><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">-</span><p id="par0065" class="elsevierStylePara elsevierViewall">Neonatal sepsis&#58; presence of microbial growth in culture of blood or cerebrospinal fluid &#40;CSF&#41; samples from the patient and clinical manifestations suggestive of infection&#46; In cases where the bacterium isolated from blood or CSF was coagulase-negative <span class="elsevierStyleItalic">Staphylococcus</span>&#44; diagnosis required 2 or more positive blood cultures or detection of abnormal white blood cell counts and glucose levels in CSF analysis&#46; Sepsis was classified as early-onset if it manifested in the first 72<span class="elsevierStyleHsp" style=""></span>h of life&#44; and as late-onset otherwise&#46;</p></li><li class="elsevierStyleListItem" id="lsti0020"><span class="elsevierStyleLabel">-</span><p id="par0070" class="elsevierStylePara elsevierViewall">Chronic lung disease&#58; oxygen dependency at 36 weeks of postmenstrual age or at hospital discharge in preterm newborns delivered before 32 weeks&#8217; gestation&#59; in patients delivered at 32 weeks&#8217; gestation or later&#44; it was diagnosed if they were oxygen-dependent for more than 28 days post birth&#46;</p></li><li class="elsevierStyleListItem" id="lsti0025"><span class="elsevierStyleLabel">-</span><p id="par0075" class="elsevierStylePara elsevierViewall">Cause of death &#40;primary cause&#41;&#58; illness or lesion that started the chain of pathological events that led to death&#46; It was assessed by 3 paediatric neonatologists and the cause was assigned if there was agreement in 2 or more of their opinions&#46;</p></li></ul></p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Statistical analysis</span><p id="par0080" class="elsevierStylePara elsevierViewall">We performed a descriptive analysis of the total sample and then we classified the cohort according to the history of antenatal corticosteroid administration&#46; We summarised qualitative variables as absolute frequencies and quantitative variables as mean&#44; standard deviation &#40;SD&#41; and range&#46; We compared proportions with the chi square test or the Fisher exact test and means with the Student <span class="elsevierStyleItalic">t</span> test or the Fisher exact test&#46; We defined statistical significance as a <span class="elsevierStyleItalic">P</span>-value of less than &#46;05&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">We analysed the association between administration of antenatal corticosteroids and the dependent variables by means of the chi square test&#44; followed by a logistic regression analysis in which we adjusted the groups by birth weight and gestational age&#46; We performed these analyses for the overall sample and for the subset of patients born before 34 weeks&#8217; gestation&#46; To analyse the impact of corticosteroids across time&#44; we performed a survival analysis&#44; plotting Kaplan&#8211;Meier curves and using the log-rank test for hypothesis testing&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">We used the IBM SPSS Statistics software version 20 for the analysis&#46; The project was approved by the ethics and research committees of the HCGJIM under file number 0184&#47;17&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Results</span><p id="par0095" class="elsevierStylePara elsevierViewall">During the period under study&#44; the unit admitted 1083 preterm newborns&#44; 53&#46;3&#37; &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>577&#41; male&#44; 46&#46;4&#37; &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>503&#41; female&#44; and 3 with ambiguous genitalia&#46; Their mean gestational age was 33&#46;4 weeks &#40;maximum&#44; 36&#46;6&#59; minimum&#44; 24&#59; SD&#44; 2&#46;73&#41;&#59; 46&#46;6&#37; &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>505&#41; were born before 34 weeks&#8217; gestation and 25&#46;3&#37; &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>274&#41; at or before 32 weeks&#8217; gestation&#46; The mean birth weight was 1765&#46;1<span class="elsevierStyleHsp" style=""></span>g &#40;maximum&#44; 3775&#59; minimum&#44; 410&#59; SD&#44; 606&#46;8&#41;&#46; Of all newborns&#44; 70&#46;7&#37; &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>766&#41; were born by caesarean section&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">Antenatal corticosteroids were given to 42&#37; of the sample &#40;455&#47;1083&#41;&#58; dexamethasone to 76&#46;9&#37; &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>350&#41; and betamethasone to 23&#46;1&#37; &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>105&#41;&#59; the full course of treatment was only completed in 61&#46;3&#37; of these patients &#40;279&#47;455&#41;&#46; Of all newborns delivered before 34 weeks&#8217; gestation&#44; 53&#46;7&#37; had been exposed to corticosteroids &#40;271&#47;505&#41;&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">In our sample&#44; 35&#37; &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>379&#41; of newborns developed RDS&#44; 4&#46;4&#37; &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>48&#41; EONS and 10&#46;7&#37; &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>116&#41; LONS&#46; A transfontanellar ultrasound was performed in 83&#46;8&#37; &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>908&#41;&#44; which led to identification of IVH in 15&#46;1&#37; &#40;137&#47;908&#41;&#44; the severity of IVH was grade <span class="elsevierStyleSmallCaps">i</span> in 33&#46;5&#37;&#44; <span class="elsevierStyleSmallCaps">ii</span> in 27&#37;&#44; <span class="elsevierStyleSmallCaps">iii</span> in 23&#46;4&#37; and <span class="elsevierStyleSmallCaps">iv</span> in 16&#46;1&#37;&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">The length of stay was of 28 days or longer in 29&#46;6&#37; of the sample &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>321&#41;&#59; within this subset&#44; 51&#46;4&#37; &#40;165&#47;321&#41; had CLD&#46; We ruled out CLD in all preterm newborns discharged before 28 days post birth&#44; as they were all discharged home without a prescription for supplemental oxygen&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">The mortality in our sample was 22&#46;3&#37; &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>242&#41;&#44; and the leading causes of death were infection &#40;28&#46;9&#37;&#59; <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>70&#41;&#44; respiratory distress syndrome &#40;23&#46;6&#37;&#59; <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>57&#41;&#44; congenital malformations or genetic disorders &#40;20&#46;7&#37;&#59; <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>50&#41; and intraventricular haemorrhage &#40;8&#46;7&#37;&#59; <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>21&#41;&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">When we compared gestational age subgroups &#40;&#60;28 weeks &#91;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>50&#93;&#44; 28&#8211;32 weeks &#91;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>224&#93;&#44; 32&#46;1&#8211;33&#46;9 weeks &#91;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>231&#93; and &#8805;34 weeks &#91;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>578&#93;&#41;&#44; we found significant differences in mortality &#40;94&#37;&#44; 44&#46;2&#37;&#44; 17&#46;3&#37;&#44; 9&#46;7&#37;&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41;&#59; respiratory distress syndrome &#40;76&#37;&#44; 77&#46;2&#37;&#44; 38&#46;5&#37;&#44; 13&#46;7&#37;&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41;&#59; chronic lung disease at 28 days post birth or later &#40;42&#46;9&#37;&#44; 56&#37;&#44; 21&#46;2&#37;&#44; 7&#46;6&#37;&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41; and intraventricular haemorrhage &#40;66&#46;7&#37;&#44; 35&#46;7&#37;&#44; 9&#46;3&#37;&#44; 6&#46;1&#37;&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41;&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">When we compared the clinical and demographic characteristics based on the administration of antenatal corticosteroids&#44; we found that patients that received this intervention had a lower gestational age and weight at birth and were more likely to have been delivered by caesarean section and have mothers with risk factors for neonatal infection &#40;urinary tract infection&#44; chorioamnionitis&#44; premature rupture of membranes or fever during labour&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0130" class="elsevierStylePara elsevierViewall">The analysis of the frequency of RDS&#44; EONS&#44; LONS&#44; IVH&#44; CLD and death by antenatal corticosteroid use did not reveal a protective effect of this intervention&#44; regardless of the administered dose or schedule&#59; in fact&#44; we found an increased incidence of RDS&#44; IVH and in patients exposed to corticosteroids &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#46; When we analysed the outcomes of this intervention adjusted for gestational age and birth weight for the total sample and the subgroup born before 34 weeks&#8217; gestation&#44; we only found a reduction in mortality &#40;37&#37;&#41; in newborns delivered before 34 weeks&#8217; gestation &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0135" class="elsevierStylePara elsevierViewall">In the group of patients exposed to corticosteroids&#44; 51&#46;9&#37; &#40;236&#47;455&#41; had latency periods of 24<span class="elsevierStyleHsp" style=""></span>h or longer&#44; and only 32&#46;9&#37; &#40;150&#47;455&#41; of 48<span class="elsevierStyleHsp" style=""></span>h or longer&#59; in 32 patients&#44; the health records did not have the information necessary to estimate the duration of latency&#46; When we compared patients that received corticosteroids with a latency of 48<span class="elsevierStyleHsp" style=""></span>h or greater and patients that did not receive corticosteroids&#44; we found a decreased risk of death &#40;60&#37;&#41; in patients that received corticosteroids born before 34 weeks&#8217; gestation&#44; without other significant effects on the remaining outcomes &#40;<a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a>&#41;&#59; we also found a protective trend that was not significant on the incidence of IVH of grades <span class="elsevierStyleSmallCaps">iii</span> and <span class="elsevierStyleSmallCaps">iv</span> in patients born before 34 weeks&#8217; gestation &#40;OR&#44; 0&#46;35&#59; 95&#37; CI&#44; 0&#46;11&#8211;1&#46;07&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;06&#41;&#46; When we analysed the dependent variables in relation to a latency period of 24<span class="elsevierStyleHsp" style=""></span>h or more&#44; we found no differences in outcomes when we compared patients treated with corticoids and untreated patients&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia><p id="par0140" class="elsevierStylePara elsevierViewall">We did not find significant differences in morbidity and mortality between patients with latency periods of 48<span class="elsevierStyleHsp" style=""></span>h or longer treated with betamethasone vs dexamethasone&#44; although there were few patients in this subset&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">We used Kaplan&#8211;Meier survival analysis to assess the effect of antenatal corticosteroids in the survival of preterm newborns admitted to the HCGJIM&#44; and found that the intervention was most beneficial in infants born before 34 week&#39;s gestation with latency periods of 48<span class="elsevierStyleHsp" style=""></span>h or longer &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Discussion</span><p id="par0150" class="elsevierStylePara elsevierViewall">It is estimated that 10&#37; of infants worldwide are born preterm&#44;<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">20</span></a> and that this group has a greater morbidity and mortality compared to full-term infants&#46;<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">18</span></a> In Mexico&#44; based on this proportion and the number of births recorded between 2014 and 2016&#44;<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">21</span></a> there would be an average of 237<span class="elsevierStyleHsp" style=""></span>000 preterm births per year&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">Since 1972&#44; there has been evidence that in preterm newborns&#44; antenatal exposure to corticosteroids reduced the risk of neonatal death through their acceleration of foetal lung maturation&#44;<a class="elsevierStyleCrossRefs" href="#bib0155"><span class="elsevierStyleSup">4&#44;9</span></a> yet to date adherence to the recommendation of this intervention has been variable&#46; In our study&#44; we found that fewer than 50&#37; of preterm newborns had been exposed to antenatal corticosteroids&#44; and that only 25&#46;8&#37; had received the full course of steroids and only 13&#46;8&#37; the full course with latency periods of 48<span class="elsevierStyleHsp" style=""></span>h or longer&#46;</p><p id="par0160" class="elsevierStylePara elsevierViewall">A trial conducted by Berrueta et al&#46;<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">22</span></a> in low- and middle-income countries revealed that despite the existence of guidelines for antenatal corticosteroid therapy&#44; this intervention was only performed in 2&#37; to 44&#37; of mothers of preterm babies&#44; with the lowest frequencies found in African countries&#46;</p><p id="par0165" class="elsevierStylePara elsevierViewall">Aleman et al&#46;<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">23</span></a> found that in Mexico&#44; 70&#37; of women in preterm labour received antenatal corticosteroids&#44; and that this proportion was lower in the group of mothers with comorbidities &#40;39&#8211;62&#46;2&#37;&#41;&#46; In addition&#44; the frequency of antenatal corticosteroid therapy was significantly higher in El Salvador and Ecuador&#46;</p><p id="par0170" class="elsevierStylePara elsevierViewall">Roberts et al&#46; found that antenatal steroids&#44; compared to placebo&#44; decreased the risk of perinatal death &#40;RR&#44; 0&#46;72&#44; 95&#37; CI 0&#46;58 to 0&#46;89&#41;&#44; respiratory distress syndrome &#40;RR&#44; 0&#46;66&#59; 95&#37; CI&#44; 0&#46;56&#8211;0&#46;77&#41;&#44; intraventricular haemorrhage &#40;RR&#44; 0&#46;55&#59; 95&#37; CI&#58; 0&#46;40&#8211;0&#46;76&#41;&#44; and systemic infection in the first 48<span class="elsevierStyleHsp" style=""></span>h post birth &#40;RR&#44; 0&#46;60&#59; 95&#37; CI&#58; 0&#46;41&#8211;0&#46;88&#41;&#46; They concluded that there was sufficient evidence to recommend this intervention&#59; however&#44; given that most studies have been conducted in developed countries&#44; there is little evidence on the outcomes of this intervention in low-income countries&#44; where the incidence of infection is high&#46;<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">9</span></a></p><p id="par0175" class="elsevierStylePara elsevierViewall">Previous studies suggest that the greatest benefit of antenatal corticosteroids is achieved when birth occurs 24&#8211;48<span class="elsevierStyleHsp" style=""></span>h after the administration of the first dose&#46;<a class="elsevierStyleCrossRefs" href="#bib0165"><span class="elsevierStyleSup">6&#44;24</span></a> In our study&#44; we found a significant decrease in the risk of mortality &#40;37&#37;&#41; associated with the use of antenatal corticosteroids in the group of patients born before 34 weeks&#8217; gestation&#44; and when we analysed the specific subset with a latency period of 48 or more hours&#44; we found an even greater decrease in risk &#40;60&#37;&#41;&#59; we did not find statistically significant differences in the incidence of RDS&#44; EONS&#44; LONS&#44; IVH or CLD&#46;</p><p id="par0180" class="elsevierStylePara elsevierViewall">It is likely that in our patients in the HCGJIM&#44; the limited impact on neonatal mortality was due to the low proportion of preterm newborns that had been subject to this intervention with latency periods greater than 24&#8211;48<span class="elsevierStyleHsp" style=""></span>h&#44; although it would be necessary to evaluate the effect of other interventions&#44; such as prenatal care&#44; the treatment of maternal comorbidities&#44; the appropriate delivery of neonatal intensive care&#44; the administration of surfactant and the prophylactic use of caffeine&#46;</p><p id="par0185" class="elsevierStylePara elsevierViewall">When we assessed the effecs of the intervention by gestational age groups without adjusting for any other variables&#44; we found the greatest benefit in newborns delivered between 32 and 33&#46;9 weeks&#8217; gestation &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>231&#41; in terms of a reduction in neonatal mortality &#40;OR&#44; 0&#46;41&#59; 95&#37; CI&#44; 0&#46;20&#8211;0&#46;85&#41;&#46; We did not find significant changes in mortality in any subgroup&#46; Our findings were consistent with those of Gyamfi-Bannerman et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">8</span></a> who did not find changes in mortality in late preterm newborns in association with exposure to antenatal corticosteroids&#59; however&#44; these authors did observe a reduction in the incidence of respiratory disease&#46;</p><p id="par0190" class="elsevierStylePara elsevierViewall">Norman et al&#46;<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">25</span></a> evaluated the effect of antenatal corticosteroids based on the time elapsed from administration of the first dose to birth and found a stronger impact on mortality when the latency period was greater than 24<span class="elsevierStyleHsp" style=""></span>h &#40;OR&#44; 0&#46;5&#59; 95&#37; CI&#44; 0&#46;4&#8211;0&#46;6&#41;&#46; Nevertheless&#44; their findings suggested that a latency period of 3<span class="elsevierStyleHsp" style=""></span>h can already reduce risk &#40;26&#37;&#41;&#46; The authors did not find any decreases in morbidity in patients with latency periods greater than 7 days&#46;</p><p id="par0195" class="elsevierStylePara elsevierViewall">In a study of low- and middle-income countries&#44; Althabe et al&#46;<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">26</span></a> did not find a decrease in the risk of neonatal death &#40;RR&#44; 0&#46;96&#44; 95&#37; CI&#44; 0&#46;87&#8211;1&#46;06&#41; after increasing the frequency of administration of antenatal corticosteroids from 10&#37; to 45&#37;&#44; but they found an increase in mortality in exposed patients of 12&#46;7&#37; &#40;from 23&#46;9 deaths per 1000 live births to 27&#46;4 deaths per 1000 live births&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;01&#41;&#46; There was also an increase in the incidence of maternal infection &#40;RR&#44; 1&#46;45&#59; 95&#37; CI&#44; 1&#46;33&#8211;1&#46;58&#41;&#46;</p><p id="par0200" class="elsevierStylePara elsevierViewall">A secondary analysis by these authors suggested that the increase in mortality was associated with deaths due to bacterial infection &#40;RR&#44; 1&#46;36&#59; 95&#37; CI&#44; 1&#46;12&#8211;1&#46;65&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">27</span></a> In our patients at the HCGJIM&#44; we found that the risk of death due to bacterial infection increased as gestational age decreased &#40;RR&#44; 1&#46;17&#59; 95&#37; CI&#44; 1&#46;09&#8211;1&#46;26&#41;&#44; and found no correlation with the use of antenatal corticosteroids &#40;RR&#44; 1&#46;34&#59; 95&#37; CI&#44; 0&#46;81&#8211;2&#46;20&#41;&#46;</p><p id="par0205" class="elsevierStylePara elsevierViewall">Similar to what we found in our patients&#44; Sasaki et al&#46;<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">10</span></a> described a frequency of corticosteroid use in preterm newborns delivered before 34 weeks&#8217; gestation of 40&#46;6&#37; and a significant reduction in neonatal mortality&#44; with no associated reduction in the incidence of RDS&#46; When they analysed outcomes based on mode of delivery&#44; they found that administration of antenatal corticosteroids was associated with a reduced risk of RDS in newborns product of vaginal deliveries&#46; In our study at the HCGJIM&#44; when we adjusted the analysis of outcomes based on mode of delivery we found no changes in the risk of RDS &#40;OR&#44; 1&#46;12&#59; 95&#37; CI&#44; 0&#46;82&#8211;1&#46;53&#41;&#46;</p><p id="par0210" class="elsevierStylePara elsevierViewall">The main limitation of this study is the low number of patients that completed the full course of antenatal corticosteroids or with latency periods of 48<span class="elsevierStyleHsp" style=""></span>h or greater&#46; Given that we only included patients born preterm that required admission at birth&#44; it is possible that there was selection bias&#59; however&#44; we ought to note that all patients born before 34 weeks&#8217; gestation or with low birth weight were admitted to the unit&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Conflicts of interest</span><p id="par0215" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:12 [
        0 => array:3 [
          "identificador" => "xres1226747"
          "titulo" => "Abstract"
          "secciones" => array:4 [
            0 => array:2 [
              "identificador" => "abst0005"
              "titulo" => "Introduction"
            ]
            1 => array:2 [
              "identificador" => "abst0010"
              "titulo" => "Methods"
            ]
            2 => array:2 [
              "identificador" => "abst0015"
              "titulo" => "Results"
            ]
            3 => array:2 [
              "identificador" => "abst0020"
              "titulo" => "Conclusions"
            ]
          ]
        ]
        1 => array:2 [
          "identificador" => "xpalclavsec1140314"
          "titulo" => "Keywords"
        ]
        2 => array:3 [
          "identificador" => "xres1226748"
          "titulo" => "Resumen"
          "secciones" => array:4 [
            0 => array:2 [
              "identificador" => "abst0025"
              "titulo" => "Introducci&#243;n"
            ]
            1 => array:2 [
              "identificador" => "abst0030"
              "titulo" => "M&#233;todos"
            ]
            2 => array:2 [
              "identificador" => "abst0035"
              "titulo" => "Resultados"
            ]
            3 => array:2 [
              "identificador" => "abst0040"
              "titulo" => "Conclusiones"
            ]
          ]
        ]
        3 => array:2 [
          "identificador" => "xpalclavsec1140313"
          "titulo" => "Palabras clave"
        ]
        4 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Introduction"
        ]
        5 => array:2 [
          "identificador" => "sec0010"
          "titulo" => "Methods"
        ]
        6 => array:2 [
          "identificador" => "sec0015"
          "titulo" => "Definitions"
        ]
        7 => array:2 [
          "identificador" => "sec0020"
          "titulo" => "Statistical analysis"
        ]
        8 => array:2 [
          "identificador" => "sec0025"
          "titulo" => "Results"
        ]
        9 => array:2 [
          "identificador" => "sec0030"
          "titulo" => "Discussion"
        ]
        10 => array:2 [
          "identificador" => "sec0035"
          "titulo" => "Conflicts of interest"
        ]
        11 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2018-08-01"
    "fechaAceptado" => "2018-11-21"
    "PalabrasClave" => array:2 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec1140314"
          "palabras" => array:4 [
            0 => "Neonatal mortality"
            1 => "Neonatal sepsis"
            2 => "Neonatal respiratory distress syndrome"
            3 => "Cerebral intraventricular haemorrhage"
          ]
        ]
      ]
      "es" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec1140313"
          "palabras" => array:4 [
            0 => "Mortalidad neonatal"
            1 => "Sepsis neonatal"
            2 => "S&#237;ndrome de distr&#233;s respiratorio neonatal"
            3 => "Hemorragia intraventricular cerebral"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introduction</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Prenatal corticosteroids reduce neonatal mortality and morbidity&#59; however&#44; there are few studies in developing countries&#44; and with inconsistent results&#46; The purpose of this study was to quantify the frequency of the use of prenatal corticosteroids and to estimate its effect on the morbidity and mortality of premature newborns&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">A retrospective cohort study was performed on premature newborns selected from a census conducted between January 2016 and August 2017&#46; The use of corticosteroids was taken from the maternal records&#44; and the dependent variables from the neonatal records&#46; An analysis was made of the relationship using logistic regression&#44; adjusted to gestational age and weight&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">The study included 1083 premature infants of which 53&#46;3&#37; were male&#46; The mean gestational age was 33&#46;4 weeks&#46; Corticosteroids were received by 42&#37;&#44; with latency &#8805;24<span class="elsevierStyleHsp" style=""></span>h in 23&#46;6&#37; and &#8805;48<span class="elsevierStyleHsp" style=""></span>h in 13&#46;8&#37;&#46; Respiratory distress syndrome was observed in 35&#37; &#40;379&#47;1083&#41;&#44; early neonatal sepsis in 4&#46;4&#37; &#40;48&#47;1083&#41;&#44; late neonatal sepsis in 10&#46;7&#37; &#40;116&#47;1083&#41;&#44; intraventricular haemorrhage in 15&#46;1&#37; &#40;137&#47;908&#41;&#44; chronic lung disease in 51&#46;4&#37; &#40;165&#47;321&#41;&#44; and death in 22&#46;3&#37; &#40;242&#47;1083&#41;&#46; Prenatal corticosteroids decreased the risk of death in children under 34 weeks &#40;OR 0&#46;63&#44; 95&#37; CI 0&#46;40&#8211;0&#46;98&#41;&#46; The decrease was greater if they presented with latency &#8805;48<span class="elsevierStyleHsp" style=""></span>h &#40;OR 0&#46;40&#44; 95&#37; CI 0&#46;20&#8211;0&#46;80&#41;&#46; The rest of the dependent variables were not modified by the intervention&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">In preterm infants&#44; 42&#37; received antenatal corticosteroids&#46; In those with less than 34 weeks&#44; there was a decrease in the risk of death without changes in morbidity&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Introduction"
          ]
          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Methods"
          ]
          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "Results"
          ]
          3 => array:2 [
            "identificador" => "abst0020"
            "titulo" => "Conclusions"
          ]
        ]
      ]
      "es" => array:3 [
        "titulo" => "Resumen"
        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introducci&#243;n</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Los corticosteroides prenatales disminuyen la morbimortalidad neonatal&#44; sin embargo&#44; existen pocos estudios en pa&#237;ses en v&#237;as de desarrollo&#44; con resultados no consistentes&#46; El objetivo fue cuantificar la frecuencia del uso de corticosteroides prenatales y estimar su efecto en la morbimortalidad de reci&#233;n nacidos prematuros&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">M&#233;todos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Estudio de cohorte retrospectivo&#59; se seleccionaron los reci&#233;n nacidos prematuros de un censo realizado entre enero de 2016 y agosto de 2017&#46; De los expedientes maternos se registr&#243; el uso de corticosteroides&#59; y de los expedientes de los neonatos se indag&#243; las variables dependientes&#46; La asociaci&#243;n se analiz&#243; con regresi&#243;n log&#237;stica&#44; ajustada a la edad gestacional y el peso&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Se estudiaron 1&#46;083 prematuros&#44; el 53&#44;3&#37; de g&#233;nero masculino&#59; la edad gestacional promedio fue 33&#44;4 semanas&#46; Recibieron corticosteroides el 42&#37;&#44; con latencia &#8805;24<span class="elsevierStyleHsp" style=""></span>horas el 23&#44;6&#37; y &#8805;48<span class="elsevierStyleHsp" style=""></span>horas el 13&#44;8&#37;&#46; Presentaron s&#237;ndrome de dificultad respiratoria el 35&#37; &#40;379&#47;1083&#41;&#44; sepsis neonatal temprana el 4&#44;4&#37; &#40;48&#47;1083&#41;&#44; sepsis neonatal tard&#237;a el 10&#44;7&#37; &#40;116&#47;1083&#41;&#44; hemorragia intraventricular el 15&#44;1&#37; &#40;137&#47;908&#41;&#44; enfermedad pulmonar cr&#243;nica el 51&#44;4&#37; &#40;165&#47;321&#41; y muerte el 22&#44;3&#37; &#40;242&#47;1083&#41;&#46; Los corticosteroides prenatales disminuyeron el riesgo de muerte en menores de 34 semanas &#40;OR&#58; 0&#44;63&#44; IC 95&#37;&#58; 0&#44;40-0&#44;98&#41;&#59; el decremento fue mayor si presentaron latencia &#8805;48<span class="elsevierStyleHsp" style=""></span>horas &#40;OR&#58; 0&#44;40&#59; IC 95&#37;&#58; 0&#44;20-0&#44;80&#41;&#46; El resto de variables dependientes no se modific&#243; por la intervenci&#243;n&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusiones</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">El 42&#37; de los prematuros recibe corticosteroides prenatales&#46; En menores de 34 semanas se observ&#243; una disminuci&#243;n del riesgo de muerte sin modificaci&#243;n en la morbilidad&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0025"
            "titulo" => "Introducci&#243;n"
          ]
          1 => array:2 [
            "identificador" => "abst0030"
            "titulo" => "M&#233;todos"
          ]
          2 => array:2 [
            "identificador" => "abst0035"
            "titulo" => "Resultados"
          ]
          3 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "Conclusiones"
          ]
        ]
      ]
    ]
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0050">Please cite this article as&#58; P&#233;rez-Ram&#237;rez RO&#44; Lona-Reyes JC&#44; Ochoa-Meza CA&#44; G&#243;mez-Ruiz LM&#44; Ramos-Guti&#233;rrez RY&#44; Camarena-Pulido EE&#44; et al&#46; Morbimortalidad neonatal en un entorno de baja adherencia a corticosteroides prenatales&#46; An Pediatr &#40;Barc&#41;&#46; 2019&#59;91&#58;105&#8211;111&#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"
            "Alto" => 2374
            "Ancho" => 2945
            "Tamanyo" => 232086
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Survival of hospitalised preterm newborns by administration of antenatal corticosteroids&#44; with a latency period of 48 or more hours&#44; and in the subset of newborns born before 34 weeks&#8217; gestation&#46;</p> <p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Survival of hospitalised preterm newborns &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1083&#41;&#46;</p> <p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Preterm newborns exposed to corticosteroids vs not exposed &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1083&#41;&#44; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;30 &#40;log rank&#41;&#46;</p> <p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Preterm newborns treated with corticosteroids with a latency period &#8805;48<span class="elsevierStyleHsp" style=""></span>h vs not treated with corticosteroids &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>778&#41;&#44; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;34 &#40;log-rank test&#41;&#46;</p> <p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Preterm newborns born before 34 weeks that received corticosteroids with a latency period &#8805;48<span class="elsevierStyleHsp" style=""></span>h vs preterm newborns &#60;34 weeks not treated with corticosteroids &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>310&#41;&#44; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;009 &#40;log-rank test&#41;&#46;</p>"
        ]
      ]
      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: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="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Corticosteroids<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>455&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">No corticosteroids<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>628&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" 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\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Weight &#40;g&#44; mean&#41;<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1599&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1884&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Gestational age &#40;weeks&#44; mean&#41;<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">32&#46;66&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">33&#46;87&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5-Minute Apgar score &#40;mean&#41;<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&#46;03&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&#46;86&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Male sex &#40;&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">53&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">52&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Caesarean delivery &#40;&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">77&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">65&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Maternal risk factors<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">c</span></a> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">41&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab2096126.png"
              ]
            ]
          ]
          "notaPie" => array:3 [
            0 => array:3 [
              "identificador" => "tblfn0005"
              "etiqueta" => "a"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Student <span class="elsevierStyleItalic">t</span> test&#46;</p>"
            ]
            1 => array:3 [
              "identificador" => "tblfn0010"
              "etiqueta" => "b"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Chi square test&#46;</p>"
            ]
            2 => array:3 [
              "identificador" => "tblfn0015"
              "etiqueta" => "c"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0015">Maternal risk factors for infection&#58; urinary tract infection&#44; chorioamnionitis&#44; premature rupture of membranes or fever during labour&#46;</p>"
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Clinical and demographic characteristics of hospitalised preterm newborns based on the prenatal administration of corticosteroids&#46;</p>"
        ]
      ]
      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: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="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Prenatal corticosteroids<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>455&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">No corticosteroids<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>628&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">P</span><a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Respiratory distress syndrome &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">43&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">28&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Early-onset neonatal sepsis &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Late-onset neonatal sepsis &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Intraventricular haemorrhage &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;04&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Bronchopulmonary dysplasia &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">24&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Death &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">25&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;04&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab2096128.png"
              ]
            ]
          ]
          "notaPie" => array:1 [
            0 => array:3 [
              "identificador" => "tblfn0020"
              "etiqueta" => "a"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0020">Chi square test&#46;</p>"
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Morbidity and mortality in hospitalised preterm newborns based on the use of prenatal corticosteroids&#46;</p>"
        ]
      ]
      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: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="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Total sample<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1083OR &#40;95&#37; CI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Gestational age &#60;34 weeks<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>505OR &#40;95&#37; CI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Respiratory distress syndrome&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;16 &#40;0&#46;85&#8211;1&#46;57&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;25 &#40;0&#46;84&#8211;1&#46;87&#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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Early-onset neonatal sepsis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;53 &#40;0&#46;84&#8211;2&#46;77&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;05 &#40;0&#46;44&#8211;2&#46;48&#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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Late-onset neonatal sepsis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;09 &#40;0&#46;73&#8211;1&#46;62&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;08 &#40;0&#46;66&#8211;1&#46;77&#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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Intraventricular haemorrhage<a class="elsevierStyleCrossRef" href="#tblfn0025"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;81 &#40;0&#46;53&#8211;1&#46;23&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;76 &#40;0&#46;47&#8211;1&#46;25&#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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Bronchopulmonary dysplasia<a class="elsevierStyleCrossRef" href="#tblfn0030"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;94 &#40;0&#46;59&#8211;1&#46;50&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;02 &#40;0&#46;59&#8211;1&#46;80&#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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Death&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;73 &#40;0&#46;52&#8211;1&#46;04&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;63 &#40;0&#46;40&#8211;0&#46;98&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab2096129.png"
              ]
            ]
          ]
          "notaPie" => array:2 [
            0 => array:3 [
              "identificador" => "tblfn0025"
              "etiqueta" => "a"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0025">Only includes patients that underwent a transfontanellar ultrasound scan &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>908&#47;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>431&#41;&#46;</p>"
            ]
            1 => array:3 [
              "identificador" => "tblfn0030"
              "etiqueta" => "b"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0030">Only includes patients aged more than 28 days &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>321&#47;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>226&#41;&#46;</p>"
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Morbidity and mortality in hospitalised preterm newborns and in the subgroup of newborns delivered before 34 weeks&#8217; gestation by use of prenatal corticosteroids &#40;adjusted for gestational age and birth weight using logistic regression&#41;&#46;</p>"
        ]
      ]
      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="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Total sample<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>778<a class="elsevierStyleCrossRef" href="#tblfn0035"><span class="elsevierStyleSup">a</span></a>OR &#40;95&#37; CI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Gestational age &#60;34 weeks<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>310<a class="elsevierStyleCrossRef" href="#tblfn0035"><span class="elsevierStyleSup">a</span></a>OR &#40;95&#37; CI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Respiratory distress syndrome&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;89 &#40;0&#46;57&#8211;1&#46;40&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;87 &#40;0&#46;48&#8211;1&#46;57&#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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Early-onset neonatal sepsis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;75 &#40;0&#46;78&#8211;3&#46;92&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;61 &#40;0&#46;13&#8211;2&#46;87&#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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Late-onset neonatal sepsis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;41 &#40;0&#46;83&#8211;2&#46;40&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;62 &#40;0&#46;84&#8211;3&#46;12&#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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Intraventricular haemorrhage<a class="elsevierStyleCrossRef" href="#tblfn0040"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;66 &#40;0&#46;35&#8211;1&#46;24&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;65 &#40;0&#46;31&#8211;1&#46;37&#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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Bronchopulmonary dysplasia<a class="elsevierStyleCrossRef" href="#tblfn0045"><span class="elsevierStyleSup">c</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;0 &#40;0&#46;53&#8211;1&#46;91&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;19 &#40;0&#46;56&#8211;2&#46;54&#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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Death&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;59 &#40;0&#46;35&#8211;1&#46;03&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;40 &#40;0&#46;20&#8211;0&#46;80&#41;<a class="elsevierStyleCrossRef" href="#tblfn0035"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab2096127.png"
              ]
            ]
          ]
          "notaPie" => array:3 [
            0 => array:3 [
              "identificador" => "tblfn0035"
              "etiqueta" => "a"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0035">Comparison of patients exposed to corticosteroids with a latency period of <span class="elsevierStyleHsp" style=""></span> &#8805;<span class="elsevierStyleHsp" style=""></span> 48<span class="elsevierStyleHsp" style=""></span> h vs patients not exposed to corticosteroids&#46;</p>"
            ]
            1 => array:3 [
              "identificador" => "tblfn0040"
              "etiqueta" => "b"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0040">Only includes patients that underwent a transfontanellar ultrasound scan &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>642&#47;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>258&#41;&#46;</p>"
            ]
            2 => array:3 [
              "identificador" => "tblfn0045"
              "etiqueta" => "c"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0045">Only includes patients aged more than 28 days &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>216&#47;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>142&#41;&#46;</p>"
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">Morbidity and mortality in hospitalised preterm newborns and in the subgroup of newborns delivered before 34 weeks&#8217; gestation by use of prenatal corticosteroids with a latency period of &#8805;48<span class="elsevierStyleHsp" style=""></span>h &#40;adjusted for gestational age and birth weight using logistic regression&#41;&#46;</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0015"
          "bibliografiaReferencia" => array:27 [
            0 => array:3 [
              "identificador" => "bib0140"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Neonatal mortality levels for 193 countries in 2009 with trends since 1990&#58; a systematic analysis of progress&#44; projections&#44; and priorities"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46;Z&#46; Oestergaard"
                            1 => "M&#46; Inoue"
                            2 => "S&#46; Yoshida"
                            3 => "W&#46;R&#46; Mahanani"
                            4 => "F&#46;M&#46; Gore"
                            5 => "S&#46; Cousens"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1371/journal.pmed.1001080"
                      "Revista" => array:5 [
                        "tituloSerie" => "PLoS Med"
                        "fecha" => "2011"
                        "volumen" => "8"
                        "paginaInicial" => "e1001080"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21918640"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0145"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Levels and causes of mortality under age five years"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "L&#46; Liu"
                            1 => "K&#46; Hill"
                            2 => "S&#46; Oza"
                            3 => "D&#46; Hogan"
                            4 => "Y&#46; Chu"
                            5 => "S&#46; Cousens"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "LibroEditado" => array:6 [
                        "paginaInicial" => "71"
                        "paginaFinal" => "83"
                        "edicion" => "3rd ed&#46;"
                        "serieVolumen" => "vol&#46; 2"
                        "serieTitulo" => "Reproductive&#44; maternal&#44; newborn&#44; and child health&#46; Disease control priorities"
                        "serieFecha" => "2016"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0150"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Interventions to reduce maternal and newborn morbidity and mortality"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46;M&#46; G&#252;lmezoglu"
                            1 => "T&#46;A&#46; Lawrie"
                            2 => "N&#46; Hezelgrave"
                            3 => "O&#46;T&#46; Oladapo"
                            4 => "J&#46;P&#46; Souza"
                            5 => "M&#46; Gielen"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "LibroEditado" => array:6 [
                        "paginaInicial" => "115"
                        "paginaFinal" => "136"
                        "edicion" => "3rd ed&#46;"
                        "serieVolumen" => "vol&#46; 2"
                        "serieTitulo" => "Reproductive&#44; maternal&#44; newborn&#44; and child health&#46; Disease control priorities"
                        "serieFecha" => "2016"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0155"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A controlled trial of antepartum glucocorticoid treatment for prevention of the respiratory distress syndrome in premature infants"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "G&#46;C&#46; Liggins"
                            1 => "R&#46;N&#46; Howie"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Pediatrics"
                        "fecha" => "1972"
                        "volumen" => "50"
                        "paginaInicial" => "515"
                        "paginaFinal" => "525"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0160"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Antenatal corticosteroids at the beginning of the 21st century"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "C&#46;A&#46; Riley"
                            1 => "K&#46; Boozer"
                            2 => "T&#46;L&#46; King"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1542-2011.2011.00119.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Midwifery Womens Health"
                        "fecha" => "2011"
                        "volumen" => "56"
                        "paginaInicial" => "591"
                        "paginaFinal" => "597"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22060219"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0165"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Antenatal steroids&#58; can we optimize the dose&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "E&#46; Romejko-Wolniewicz"
                            1 => "J&#46; Teliga-Czajkowska"
                            2 => "K&#46; Czajkowski"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/GCO.0000000000000047"
                      "Revista" => array:6 [
                        "tituloSerie" => "Curr Opin Obstet Gynecol"
                        "fecha" => "2014"
                        "volumen" => "26"
                        "paginaInicial" => "77"
                        "paginaFinal" => "82"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24463225"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0170"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Corticoterapia prenatal y morbimortalidad del prematuro tard&#237;o&#58; estudio prospectivo"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "I&#46;M&#46; G&#225;zquez Serrano"
                            1 => "A&#46; Arroyos Plana"
                            2 => "O&#46; D&#237;az Morales"
                            3 => "C&#46; Herr&#225;iz Perea"
                            4 => "C&#46;A&#46; Holgueras Bragado"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "An Pediatr"
                        "fecha" => "2014"
                        "volumen" => "81"
                        "paginaInicial" => "374"
                        "paginaFinal" => "382"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0175"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Antenatal betamethasone for women at risk for late preterm delivery"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "C&#46; Gyamfi-Bannerman"
                            1 => "E&#46;A&#46; Thom"
                            2 => "S&#46;C&#46; Blackwell"
                            3 => "A&#46;T&#46; Tita"
                            4 => "U&#46;M&#46; Reddy"
                            5 => "G&#46;R&#46; Saade"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1056/NEJMoa1516783"
                      "Revista" => array:6 [
                        "tituloSerie" => "N Engl J Med"
                        "fecha" => "2016"
                        "volumen" => "374"
                        "paginaInicial" => "1311"
                        "paginaFinal" => "1320"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26842679"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0180"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Antenatal corticosteroids for accelerating fetal lung maturation for women at risk of preterm birth"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "D&#46; Roberts"
                            1 => "J&#46; Brown"
                            2 => "N&#46; Medley"
                            3 => "S&#46;R&#46; Dalziel"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:3 [
                        "tituloSerie" => "Cochrane Database Syst Rev"
                        "fecha" => "2017"
                        "volumen" => "3"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0185"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Association of antenatal corticosteroids and the mode of delivery with the mortality and morbidity of infants weighing less than 1&#44;500<span class="elsevierStyleHsp" style=""></span>g at birth in Japan"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "Y&#46; Sasaki"
                            1 => "T&#46; Ikeda"
                            2 => "K&#46; Nishimura"
                            3 => "S&#46; Katsuragi"
                            4 => "K&#46; Sengoku"
                            5 => "S&#46; Kusuda"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1159/000358189"
                      "Revista" => array:6 [
                        "tituloSerie" => "Neonatology"
                        "fecha" => "2014"
                        "volumen" => "106"
                        "paginaInicial" => "81"
                        "paginaFinal" => "86"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24819396"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0190"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Antenatal corticosteroids for reducing adverse maternal and child outcomes in special populations of women at risk of imminent preterm birth&#58; a systematic review and meta-analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "R&#46;M&#46; Amiya"
                            1 => "L&#46;B&#46; Mlunde"
                            2 => "E&#46; Ota"
                            3 => "T&#46; Swa"
                            4 => "O&#46;T&#46; Oladapo"
                            5 => "R&#46; Mori"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "PLOS ONE"
                        "fecha" => "2016"
                        "volumen" => "11"
                        "paginaInicial" => "e0147604"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0195"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Association of antenatal corticosteroids with mortality and neurodevelopmental outcomes among infants born at 22 to 25 weeks&#8217; gestation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "W&#46;A&#46; Carlo"
                            1 => "S&#46;A&#46; McDonald"
                            2 => "A&#46;A&#46; Fanaroff"
                            3 => "B&#46;R&#46; Vohr"
                            4 => "B&#46;J&#46; Stoll"
                            5 => "R&#46;A&#46; Ehrenkranz"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1001/jama.2011.1752"
                      "Revista" => array:6 [
                        "tituloSerie" => "JAMA"
                        "fecha" => "2011"
                        "volumen" => "306"
                        "paginaInicial" => "2348"
                        "paginaFinal" => "2358"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22147379"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0200"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Antenatal corticosteroids for women at risk of imminent preterm birth in low-resource countries&#58; the case for equipoise and the need for efficacy trials"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46;P&#46; Vogel"
                            1 => "O&#46;T&#46; Oladapo"
                            2 => "C&#46; Pileggi-Castro"
                            3 => "E&#46;A&#46; Adejuyigbe"
                            4 => "F&#46; Althabe"
                            5 => "S&#46; Ariff"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1136/bmjgh-2017-000398"
                      "Revista" => array:5 [
                        "tituloSerie" => "BMJ Glob Health"
                        "fecha" => "2017"
                        "volumen" => "2"
                        "paginaInicial" => "e000398"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29082019"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0205"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Committee Opinion No&#46; 713&#58; antenatal corticosteroid therapy for fetal maturation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "Committee on Obstetric Practice"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/AOG.0000000000002237"
                      "Revista" => array:6 [
                        "tituloSerie" => "Obstet Gynecol"
                        "fecha" => "2017"
                        "volumen" => "130"
                        "paginaInicial" => "e102"
                        "paginaFinal" => "e109"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28742678"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0210"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Different corticosteroids and regimens for accelerating fetal lung maturation for women at risk of preterm birth"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "F&#46;C&#46; Brownfoot"
                            1 => "D&#46;I&#46; Gagliardi"
                            2 => "E&#46; Bain"
                            3 => "P&#46; Middleton"
                            4 => "C&#46;A&#46; Crowther"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:2 [
                        "tituloSerie" => "Cochrane Database Syst Rev"
                        "fecha" => "2013"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0215"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "No&#46; 364-Antenatal corticosteroid therapy for improving neonatal outcomes"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46; Skoll"
                            1 => "A&#46; Boutin"
                            2 => "E&#46; Bujold"
                            3 => "J&#46; Burrows"
                            4 => "J&#46; Crane"
                            5 => "M&#46; Geary"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jogc.2018.04.018"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Obstet Gynaecol Can"
                        "fecha" => "2018"
                        "volumen" => "40"
                        "paginaInicial" => "1219"
                        "paginaFinal" => "1239"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30268316"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib0220"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Antenatal corticosteroid therapy for reduction of neonatal morbidity and mortality from preterm delivery"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "M&#46;J&#46; Lee"
                            1 => "D&#46; Guinn"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "LibroEditado" => array:3 [
                        "editores" => "C&#46;J&#46;Lockwood, R&#46;Martin"
                        "titulo" => "UpToDate"
                        "serieFecha" => "2017"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib0225"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Neonatal mortality and associated factors in newborn infants admitted to a neonatal care unit"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "J&#46;C&#46; Lona Reyes"
                            1 => "R&#46;O&#46; P&#233;rez Ram&#237;rez"
                            2 => "L&#46; Llamas Ramos"
                            3 => "L&#46;M&#46; G&#243;mez Ruiz"
                            4 => "E&#46;A&#46; Ben&#237;tez V&#225;zquez"
                            5 => "V&#46; Rodr&#237;guez Patino"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.5546/aap.2018.eng.42"
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Argent Pediatr"
                        "fecha" => "2018"
                        "volumen" => "116"
                        "paginaInicial" => "42"
                        "paginaFinal" => "48"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29333811"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib0230"
              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Diagn&#243;stico y manejo del parto pret&#233;rmino &#40;documento en l&#237;nea&#59; 37 p&#225;ginas en pantalla&#41;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "Consejo de Salubridad General"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:3 [
                        "fecha" => "2009"
                        "editorial" => "Secretar&#237;a de Salud"
                        "editorialLocalizacion" => "M&#233;xico"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib0235"
              "etiqueta" => "20"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Born too soon preterm birth action group born too soon&#58; preterm birth matters"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "C&#46;P&#46; Howson"
                            1 => "M&#46;V&#46; Kinney"
                            2 => "L&#46; McDougall"
                            3 => "J&#46;E&#46; Lawn"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1186/1742-4755-10-S1-S1"
                      "Revista" => array:6 [
                        "tituloSerie" => "Reprod Health"
                        "fecha" => "2013"
                        "volumen" => "10"
                        "numero" => "Suppl&#46; 1"
                        "paginaInicial" => "S1"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24625113"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib0240"
              "etiqueta" => "21"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Poblaci&#243;n&#46; Natalidad y fecundidad"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "Instituto Nacional de Estad&#237;stica y Geograf&#237;a"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:3 [
                        "fecha" => "2018"
                        "editorial" => "INEGI"
                        "editorialLocalizacion" => "M&#233;xico"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib0245"
              "etiqueta" => "22"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Use of antenatal corticosteroids at health facilities and communities in low- and-middle income countries"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Berrueta"
                            1 => "J&#46; Hemingway-Foday"
                            2 => "V&#46;R&#46; Thorsten"
                            3 => "R&#46;L&#46; Goldenberg"
                            4 => "W&#46;A&#46; Carlo"
                            5 => "A&#46; Garces"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1186/s12978-016-0176-2"
                      "Revista" => array:5 [
                        "tituloSerie" => "Reprod Health"
                        "fecha" => "2016"
                        "volumen" => "13"
                        "paginaInicial" => "66"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27228986"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib0250"
              "etiqueta" => "23"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Use of antenatal corticosteroids for preterm birth in Latin America&#58; providers knowledge&#44; attitudes and practices"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46; Aleman"
                            1 => "M&#46;L&#46; Cafferata"
                            2 => "L&#46; Gibbons"
                            3 => "F&#46; Althabe"
                            4 => "J&#46; Ortiz"
                            5 => "X&#46; Sandoval"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1186/1742-4755-10-4"
                      "Revista" => array:5 [
                        "tituloSerie" => "Reprod Health"
                        "fecha" => "2013"
                        "volumen" => "10"
                        "paginaInicial" => "4"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23360713"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib0255"
              "etiqueta" => "24"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Association between antenatal corticosteroid administration-to-birth interval and outcomes of preterm neonates"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "N&#46; Melamed"
                            1 => "J&#46; Shah"
                            2 => "A&#46; Soraisham"
                            3 => "E&#46;W&#46; Yoon"
                            4 => "S&#46;K&#46; Lee"
                            5 => "P&#46;S&#46; Shah"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Obstet Gynecol"
                        "fecha" => "2015"
                        "volumen" => "125"
                        "paginaInicial" => "1377"
                        "paginaFinal" => "1384"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib0260"
              "etiqueta" => "25"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Association of short antenatal corticosteroid administration-to-birth intervals with survival and morbidity among very preterm infants&#58; results from the EPICE Cohort"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "M&#46; Norman"
                            1 => "A&#46; Piedvache"
                            2 => "K&#46; B&#248;rch"
                            3 => "L&#46;D&#46; Huusom"
                            4 => "A&#46;E&#46; Bonamy"
                            5 => "E&#46;A&#46; Howell"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1001/jamapediatrics.2017.0602"
                      "Revista" => array:6 [
                        "tituloSerie" => "JAMA Pediatr"
                        "fecha" => "2017"
                        "volumen" => "171"
                        "paginaInicial" => "678"
                        "paginaFinal" => "686"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28505223"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib0265"
              "etiqueta" => "26"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A population-based&#44; multifaceted strategy to implement antenatal corticosteroid treatment versus standard care for the reduction of neonatal mortality due to preterm birth in low-income and middle-income countries&#58; the ACT cluster-randomised trial"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "F&#46; Althabe"
                            1 => "J&#46;M&#46; Beliz&#225;n"
                            2 => "E&#46;M&#46; McClure"
                            3 => "J&#46; Hemingway-Foday"
                            4 => "M&#46; Berrueta"
                            5 => "A&#46; Mazzoni"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S0140-6736(14)61651-2"
                      "Revista" => array:6 [
                        "tituloSerie" => "Lancet"
                        "fecha" => "2015"
                        "volumen" => "385"
                        "paginaInicial" => "629"
                        "paginaFinal" => "639"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25458726"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            26 => array:3 [
              "identificador" => "bib0270"
              "etiqueta" => "27"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The Antenatal Corticosteroids Trial &#40;ACT&#41;&#8217;s explanations for neonatal mortality &#8211; a secondary analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "F&#46; Althabe"
                            1 => "V&#46; Thorsten"
                            2 => "K&#46; Klein"
                            3 => "E&#46;M&#46; McClure"
                            4 => "P&#46;L&#46; Hibberd"
                            5 => "R&#46;L&#46; Goldenberg"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1186/s12978-016-0175-3"
                      "Revista" => array:5 [
                        "tituloSerie" => "Reprod Health"
                        "fecha" => "2016"
                        "volumen" => "13"
                        "paginaInicial" => "62"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27220987"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/23412879/0000009100000002/v1_201908020803/S2341287919301115/v1_201908020803/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "26005"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Original Articles"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/23412879/0000009100000002/v1_201908020803/S2341287919301115/v1_201908020803/en/main.pdf?idApp=UINPBA00005H&text.app=https://analesdepediatria.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341287919301115?idApp=UINPBA00005H"
]

Article information

ISSN: 23412879
Original language: English

DOI:10.1016/j.anpede.2018.11.015

The statistics are updated each day

Year/Month	Html	Pdf	Total

2024 November	3	0	3
2024 October	39	42	81
2024 September	41	30	71
2024 August	38	48	86
2024 July	31	22	53
2024 June	35	24	59
2024 May	43	33	76
2024 April	33	29	62
2024 March	30	24	54
2024 February	33	20	53
2024 January	24	25	49
2023 December	39	20	59
2023 November	35	31	66
2023 October	42	24	66
2023 September	27	28	55
2023 August	32	18	50
2023 July	27	17	44
2023 June	24	25	49
2023 May	29	18	47
2023 April	25	7	32
2023 March	57	20	77
2023 February	36	16	52
2023 January	19	14	33
2022 December	61	28	89
2022 November	29	27	56
2022 October	73	54	127
2022 September	35	15	50
2022 August	43	47	90
2022 July	34	46	80
2022 June	33	23	56
2022 May	43	36	79
2022 April	24	25	49
2022 March	48	39	87
2022 February	36	33	69
2022 January	46	32	78
2021 December	45	38	83
2021 November	56	42	98
2021 October	66	67	133
2021 September	30	32	62
2021 August	39	33	72
2021 July	26	22	48
2021 June	44	32	76
2021 May	92	48	140
2021 April	106	33	139
2021 March	45	17	62
2021 February	42	25	67
2021 January	40	24	64
2020 December	45	22	67
2020 November	27	16	43
2020 October	25	13	38
2020 September	55	26	81
2020 August	61	17	78
2020 July	58	10	68
2020 June	15	5	20
2020 May	37	18	55
2020 April	38	8	46
2020 March	49	10	59
2020 February	71	14	85
2020 January	32	8	40
2019 December	65	22	87
2019 November	38	8	46
2019 October	53	6	59
2019 September	36	17	53
2019 August	79	18	97
2019 July	19	15	34

Show all

Indexed in:

Follow us:

Subscribe:

Statistics

Indexed in:

Follow us:

Subscribe:

Statistics

Subscribe to our newsletter