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estudios recientes han demostrado que su morbimortalidad es mayor que la de los nacidos a t&#233;rmino debido a su inmadurez<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4-6</span></a>&#46; A pesar de constituir un grupo de riesgo&#44; muy pocas actuaciones se han llevado a cabo hasta la fecha para reducir su mayor tasa de morbimortalidad&#46; En este sentido&#44; una de las intervenciones que m&#225;s ha contribuido a mejorar el pron&#243;stico de los RN pret&#233;rmino ha sido la administraci&#243;n prenatal de corticoides<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a>&#46; Sin embargo&#44; a las 34<span class="elsevierStyleHsp" style=""></span>semanas de gestaci&#243;n el pulm&#243;n fetal se considera ya maduro&#44; por lo que no se recomienda su administraci&#243;n&#44; existiendo muy pocos estudios que eval&#250;en el efecto de los corticoides prenatales en esta poblaci&#243;n<a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">8-10</span></a>&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Con el fin de valorar la repercusi&#243;n de la administraci&#243;n prenatal de corticoides entre los PT de nuestro centro&#44; nos propusimos como objetivos&#58; describir la morbilidad asociada a la prematuridad tard&#237;a y determinar si existen diferencias entre los que recibieron corticoides prenatales&#44; as&#237; como la prevalencia&#44; la etiolog&#237;a y las condiciones obst&#233;tricas relacionadas&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Poblaci&#243;n y m&#233;todos</span><p id="par0015" class="elsevierStylePara elsevierViewall">Se realiz&#243; un estudio observacional prospectivo cuyo objetivo principal fue analizar si la administraci&#243;n prenatal de corticoides en los PT influ&#237;a en los resultados obtenidos&#46; Se seleccionaron los nacidos vivos entre las 34<span class="elsevierStyleSup">&#43;0</span> y las 36<span class="elsevierStyleSup">&#43;6</span><span class="elsevierStyleHsp" style=""></span>semanas de gestaci&#243;n en el hospital durante un a&#241;o &#40;1 de octubre de 2011 a 30 de septiembre de 2012&#41;&#46; La edad gestacional fue determinada seg&#250;n criterio obst&#233;trico bas&#225;ndose en la fecha de la &#250;ltima menstruaci&#243;n o en la ecograf&#237;a de la primera mitad de la gestaci&#243;n&#46; Se calcul&#243; la tasa de prematuridad global y de PT durante el per&#237;odo estudiado&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Los RN seleccionados se clasificaron en 2<span class="elsevierStyleHsp" style=""></span>grupos&#58; a&#41;<span class="elsevierStyleHsp" style=""></span>los que hab&#237;an recibido corticoides prenatales &#40;administraci&#243;n de una o dos dosis de 12<span class="elsevierStyleHsp" style=""></span>mg de betametasona cada 24<span class="elsevierStyleHsp" style=""></span>h intramusculares antes del parto&#41; y b&#41;<span class="elsevierStyleHsp" style=""></span>los que no los hab&#237;an recibido&#59; datos que se recogieron mediante revisi&#243;n de historias cl&#237;nicas&#46; Se excluyeron los RN fallecidos anteparto o intraparto y aquellos con malformaciones cong&#233;nitas mayores y confirmaci&#243;n o sospecha de s&#237;ndrome gen&#233;tico o cromos&#243;mico o enfermedad metab&#243;lica&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Se analiz&#243; de manera global y para cada uno de los grupos los siguientes datos&#58; necesidad de ingreso en la unidad de neonatolog&#237;a y&#47;o en la unidad de cuidados intensivos neonatales &#40;UCIN&#41;&#44; duraci&#243;n de la estancia hospitalaria&#44; mortalidad&#44; patolog&#237;a gestacional relevante&#44; parto&#44; periodo perinatal y reanimaci&#243;n inmediata&#44; trastornos respiratorios &#40;enfermedad de membrana hialina&#44; taquipnea transitoria del reci&#233;n nacido &#91;TTRN&#93;&#44; s&#237;ndrome de aspiraci&#243;n de l&#237;quido amni&#243;tico meconial y neumot&#243;rax&#41; subsidiarios de asistencia respiratoria en forma de presi&#243;n positiva continua en la v&#237;a a&#233;rea &#40;CPAP&#41; nasal o ventilaci&#243;n mec&#225;nica y administraci&#243;n de surfactante&#46; Tambi&#233;n se analiz&#243; la incidencia de ictericia que precis&#243; fototerapia&#44; hipoglucemia&#44; intolerancia digestiva&#44; necesidad de sueroterapia y nutrici&#243;n parenteral y sepsis confirmada mediante cl&#237;nica y hemocultivo&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Finalmente&#44; se analizaron todos estos par&#225;metros para cada edad gestacional y peso al nacer&#44; con el fin de conocer si exist&#237;an diferencias significativas entre los que recibieron corticoides y los que no&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Se realiz&#243; un estudio comparativo de la frecuencia de cada uno de los datos analizados entre los 2<span class="elsevierStyleHsp" style=""></span>grupos&#46; Como herramienta estad&#237;stica se utiliz&#243; el programa SPSS versi&#243;n 18&#46;0 para Windows&#46; Las variables cuantitativas se expresan como media<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>desviaci&#243;n est&#225;ndar y valores m&#225;ximos y m&#237;nimos&#46; Las variables cualitativas se expresan como frecuencias absolutas &#40;n&#41; y frecuencias relativas &#40;&#37;&#41;&#46; La comparaci&#243;n entre los grupos se realiz&#243; mediante pruebas chi-cuadrado para tablas de contingencia y el estad&#237;stico exacto de Fisher cuando alguna frecuencia esperada fue inferior a 5&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Resultados</span><p id="par0040" class="elsevierStylePara elsevierViewall">En el periodo estudiado &#40;1 de octubre de 2011 a 30 de septiembre de 2012&#41; nacieron 4&#46;127<span class="elsevierStyleHsp" style=""></span>RN vivos&#44; de los cuales 3&#46;795 fueron a t&#233;rmino y 332 pret&#233;rmino&#44; con una tasa de prematuridad global anual del 8&#44;04&#37;&#46; De estos &#250;ltimos&#44; 247 fueron PT&#44; poblaci&#243;n que supuso el 6&#37; de RN vivos y el 74&#44;4&#37; de todos los prematuros&#46; Ingresaron en la unidad de neonatolog&#237;a el 63&#44;2&#37; de los PT &#40;17&#37; del total de RN ingresados&#41;&#44; siendo su estancia media de 14&#44;70<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>11&#44;4 &#40;3-90&#41; d&#237;as&#46; De ellos&#44; el 28&#44;2&#37; precis&#243; ingreso en la UCIN con una estancia media de 7&#44;11<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>10&#44;4 &#40;1-70&#41; d&#237;as&#44; suponiendo el 20&#44;6&#37; del total de RN ingresados en la UCIN&#46; La tasa de mortalidad neonatal para los PT fue cero&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">La <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a> describe las caracter&#237;sticas generales&#44; los antecedentes obst&#233;tricos y perinatales y la morbilidad global en el periodo neonatal de los PT incluidos en el estudio&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0050" class="elsevierStylePara elsevierViewall">Los PT estudiados &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>247&#41; se dividieron en 2<span class="elsevierStyleHsp" style=""></span>grupos seg&#250;n la administraci&#243;n prenatal de corticoides&#46; Recibieron corticoides prenatales el 29&#44;6&#37; &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>73&#41;&#44; de los cuales el 98&#44;6&#37; &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>72&#41; recibieron un curso completo &#40;2<span class="elsevierStyleHsp" style=""></span>dosis de betametasona cada 24<span class="elsevierStyleHsp" style=""></span>h antes del parto&#41;&#46; La edad gestacional media de administraci&#243;n fueron 31<span class="elsevierStyleSup">&#43;6</span><span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2<span class="elsevierStyleSup">&#43;2</span> &#40;25-34<span class="elsevierStyleSup">&#43;1</span>&#41; semanas&#46; El tiempo transcurrido hasta el parto fue de 27&#44;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>15&#44;4 &#40;0-65&#41; d&#237;as&#46; En el 12&#44;5&#37; de las mujeres que recibieron un ciclo completo&#44; el parto tuvo lugar en los 7<span class="elsevierStyleHsp" style=""></span>d&#237;as siguientes a su administraci&#243;n&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">No hubo diferencias significativas entre ambos grupos en la mayor&#237;a de los antecedentes y resultados perinatales &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0060" class="elsevierStylePara elsevierViewall">El resultado del estudio comparativo entre ambos grupos acerca de la morbilidad neonatal y las necesidades de intervenci&#243;n se muestra en la <a class="elsevierStyleCrossRef" href="#tbl0015">tabla 3</a>&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0065" class="elsevierStylePara elsevierViewall">La tasa de ingreso en neonatolog&#237;a fue significativamente superior &#40;74&#37; frente al 38&#37;&#41; en los PT que no recibieron corticoides prenatales&#46; La necesidad de ingreso en la UCIN tambi&#233;n fue significativamente superior en este grupo &#40;22&#37; frente al 8&#37;&#41;&#46; Todas las patolog&#237;as asociadas a la prematuridad tard&#237;a fueron menos frecuentes en el grupo que recibi&#243; corticoides prenatales&#44; siendo estas diferencias significativas para la TTRN&#44; la presencia de hipoglucemia&#44; intolerancia digestiva e ictericia que precisa fototerapia&#46; Asimismo&#44; la necesidad de t&#233;cnicas de asistencia respiratoria en forma de oxigenoterapia y CPAP nasal y los requerimientos de sueroterapia y nutrici&#243;n parenteral fueron significativamente superiores en el grupo de PT que no recibieron corticoides prenatales&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">En el an&#225;lisis comparativo seg&#250;n edad gestacional se observan diferencias significativas semana a semana&#44; existiendo un evidente descenso a medida que se incrementa la edad gestacional &#40;<a class="elsevierStyleCrossRef" href="#tbl0020">tabla 4</a>&#41;&#46; Todas las patolog&#237;as y necesidades de intervenci&#243;n fueron menos frecuentes en los que recibieron corticoides prenatales a cualquier edad gestacional&#44; siendo de nuevo esta disminuci&#243;n significativa para la TTRN&#44; la intolerancia digestiva&#44; la ictericia y la necesidad de fototerapia&#44; sueroterapia y CPAP nasal &#40;<a class="elsevierStyleCrossRef" href="#tbl0025">tabla 5</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia><elsevierMultimedia ident="tbl0025"></elsevierMultimedia><p id="par0075" class="elsevierStylePara elsevierViewall">Por &#250;ltimo&#44; al analizar estos datos seg&#250;n el peso al nacer se corrobora que a menor peso hay mayores riesgos&#44; especialmente para los problemas de alimentaci&#243;n y las necesidades de sueroterapia y nutrici&#243;n parenteral&#44; que fueron significativamente m&#225;s frecuentes &#40;<a class="elsevierStyleCrossRef" href="#tbl0030">tabla 6</a>&#41;&#46; La morbilidad fue mayor entre todos los PT que no recibieron corticoterapia prenatal&#44; aunque estas diferencias solo fueron significativas para los &#62;<span class="elsevierStyleHsp" style=""></span>2&#46;000<span class="elsevierStyleHsp" style=""></span>g&#44; por constituir el grupo m&#225;s frecuente &#40;<a class="elsevierStyleCrossRef" href="#tbl0035">tabla 7</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0030"></elsevierMultimedia><elsevierMultimedia ident="tbl0035"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Discusi&#243;n</span><p id="par0080" class="elsevierStylePara elsevierViewall">De manera similar a la bibliograf&#237;a revisada&#44; la tasa de prematuridad global en este centro durante el periodo de tiempo estudiado fue del 8&#44;04&#37;&#46; Dentro de este grupo&#44; el 74&#44;4&#37; pertenecieron al subgrupo de PT&#46; Estos datos coinciden con los publicados en la mayor&#237;a de pa&#237;ses desarrollados donde&#44; adem&#225;s&#44; se describe una tendencia creciente<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;11&#44;12</span></a>&#46; Entre las causas implicadas se encuentran la edad materna avanzada en prim&#237;paras&#44; el embarazo m&#250;ltiple&#44; las t&#233;cnicas de reproducci&#243;n asistida y el aumento de indicaciones m&#233;dicas para la inducci&#243;n del parto o ces&#225;rea programada&#46; En este estudio el 42&#44;5&#37; de las madres ten&#237;an &#8805;<span class="elsevierStyleHsp" style=""></span>35<span class="elsevierStyleHsp" style=""></span>a&#241;os&#59; eran prim&#237;paras el 46&#44;6&#37;&#59; el 7&#44;7&#37; de los embarazos se consiguieron mediante t&#233;cnicas de reproducci&#243;n asistida&#59; el 24&#44;1&#37; fueron gestaciones m&#250;ltiples&#44; y en el 41&#44;7&#37; el parto fue inducido por indicaci&#243;n materna o fetal&#44; cifras que coinciden con las reflejadas en la literatura<a class="elsevierStyleCrossRefs" href="#bib0065"><span class="elsevierStyleSup">13-17</span></a>&#46; Estos resultados no resultan extra&#241;os si tenemos en cuenta que todos estos factores se encuentran relacionados entre s&#237;&#46; La edad materna avanzada se asocia con un mayor riesgo de complicaciones obst&#233;tricas&#44; que en muchas ocasiones son la indicaci&#243;n para la finalizaci&#243;n de la gestaci&#243;n&#44; y tambi&#233;n es m&#225;s frecuente la necesidad de t&#233;cnicas de reproducci&#243;n asistida que aumentan la probabilidad de embarazo m&#250;ltiple&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">En este trabajo&#44; el 63&#44;2&#37; de los PT ingresaron en la unidad de neonatolog&#237;a y el 28&#44;2&#37; precisaron cuidados intensivos neonatales&#44; generando un importante n&#250;mero de estancias hospitalarias al constituir el grupo m&#225;s frecuente de prematuros&#46; Representan el 17&#37; del total de RN ingresados y el 20&#44;6&#37; del total de ingresos en la UCIN&#46; En este centro los criterios generales de ingreso son todos los RN de &#8804;<span class="elsevierStyleHsp" style=""></span>34<span class="elsevierStyleHsp" style=""></span>semanas de gestaci&#243;n y los RN<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>34<span class="elsevierStyleHsp" style=""></span>semanas con peso al nacer &#60;<span class="elsevierStyleHsp" style=""></span>2&#46;300<span class="elsevierStyleHsp" style=""></span>g o con cualquier patolog&#237;a que requiera monitorizaci&#243;n y&#47;o tratamiento&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">Durante la &#250;ltima d&#233;cada son numerosas las investigaciones que confirman&#44; de manera repetida&#44; que presentan una morbilidad mayor que los nacidos a t&#233;rmino debido a su inmadurez&#46; Los PT estudiados presentaron una frecuencia de enfermedades respiratorias&#44; ictericia&#44; hipoglucemia&#44; dificultades en la alimentaci&#243;n y sepsis similares a las descritas en la literatura<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4&#44;18-22</span></a>&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">La inducci&#243;n farmacol&#243;gica de la madurez pulmonar fetal con corticoides ha sido la intervenci&#243;n que m&#225;s ha cambiado el pron&#243;stico de los RN prematuros&#46; Como resultado&#44; las Sociedades Americana y Espa&#241;ola de Obstetricia y Ginecolog&#237;a recomiendan la administraci&#243;n prenatal de corticoides a gestantes con riesgo de parto pret&#233;rmino entre las 24 y las 34<span class="elsevierStyleHsp" style=""></span>semanas de gestaci&#243;n&#44; con el objetivo de reducir la incidencia de distr&#233;s respiratorio agudo&#44; hemorragia intraventricular&#44; enterocolitis necrosante y&#47;o muerte neonatal<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">23</span></a>&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">En este trabajo recibieron corticoides prenatales el 29&#44;6&#37; &#40;73&#41; de los PT&#44; siendo su tasa de ingreso tanto en la unidad neonatal &#40;74&#37; vs&#46; 38&#37;&#41; como en la UCIN &#40;22&#37; vs&#46; 8&#37;&#41; significativamente superior en los que no los recibieron&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">Dentro de la morbilidad asociada a la prematuridad tard&#237;a&#44; la patolog&#237;a respiratoria es una de las m&#225;s frecuentes&#46; En este estudio&#44; el 27&#44;1&#37; de los PT presentaron complicaciones respiratorias&#44; siendo la TTRN el diagn&#243;stico m&#225;s frecuente &#40;20&#44;2&#37;&#41;&#46; Esta alta incidencia podr&#237;a explicarse por la existencia de alteraciones o retraso en la eliminaci&#243;n del l&#237;quido pulmonar fetal tras el nacimiento&#46; Varias investigaciones proponen el transporte de sodio a trav&#233;s del epitelio alveolar como el principal mecanismo implicado en la reabsorci&#243;n del l&#237;quido pulmonar fetal&#44; actividad que se desarrolla a medida que avanza la edad gestacional&#44; siendo especialmente importante en las &#250;ltimas semanas de gestaci&#243;n&#46; En los PT&#44; el menor n&#250;mero as&#237; como la inmadurez de los mecanismos transportadores de sodio podr&#237;an estar implicadas en la patog&#233;nesis de la TTRN<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">24</span></a>&#46; En el grupo de PT que no recibieron corticoides la incidencia de TTRN fue significativamente superior a la encontrada en el grupo que s&#237; los recibi&#243;&#58; 28&#37; versus 2&#44;7&#37; &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;0001&#41;&#46; Esta diferencia parece tener su explicaci&#243;n en que solamente los glucocorticoides parecen estimular la s&#237;ntesis y la actividad de los canales de sodio del epitelio alveolar&#44; incrementando as&#237; la reabsorci&#243;n de l&#237;quido pulmonar&#46; Se sabe que durante el parto vaginal espont&#225;neo a t&#233;rmino se produce un aumento de los esteroides end&#243;genos y catecolaminas&#44; cambios hormonales necesarios para la maduraci&#243;n y preparaci&#243;n del feto para una transici&#243;n neonatal correcta&#46; Esta ser&#237;a la raz&#243;n por la que en los PT que no han recibido corticoides prenatales la presencia de TTRN se ve incrementada&#44; m&#225;s a&#250;n en los nacidos por ces&#225;rea&#44; circunstancia que&#44; como hemos referido anteriormente&#44; es m&#225;s frecuente en este grupo &#40;32&#44;4&#37;&#41;<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">25</span></a>&#46; En este trabajo&#44; los casos de TTRN nacieron en la misma proporci&#243;n mediante ces&#225;rea y por v&#237;a vaginal&#46; En cada grupo&#44; solo uno recibi&#243; corticoides antenatales&#46; Seg&#250;n estos resultados&#44; la corticoterapia prenatal disminuye el riesgo de TTRN&#44; sea cual sea el mecanismo del parto&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">El inter&#233;s del tema radica en que dicha patolog&#237;a es muy frecuente y el principal motivo de ingreso de los PT&#46; A la hora de decidir a qu&#233; edad gestacional se recomienda la administraci&#243;n prenatal de corticoides no solo influye la frecuencia de la enfermedad &#40;los PT presentan menos morbilidad respiratoria que los prematuros de una edad gestacional inferior&#41;&#44; sino tambi&#233;n el n&#250;mero total de pacientes que se ver&#237;an beneficiados&#46; Como ya hemos referido&#44; los PT constituyen el grupo m&#225;s frecuente de prematuros&#44; por lo que se reducir&#237;a el n&#250;mero total de pacientes que ingresar&#237;an en la UCIN&#44; lo que supone un menor coste socioecon&#243;mico<a class="elsevierStyleCrossRefs" href="#bib0130"><span class="elsevierStyleSup">26-28</span></a>&#46; En este mismo sentido&#44; la Cochrane apoya la administraci&#243;n prenatal de corticoides hasta las 34<span class="elsevierStyleSup">&#43;6</span><span class="elsevierStyleHsp" style=""></span>semanas de gestaci&#243;n&#46; Esta recomendaci&#243;n se basa en la disminuci&#243;n de la aparici&#243;n de s&#237;ndrome de distr&#233;s respiratorio en el subgrupo de prematuros entre 33 y 34<span class="elsevierStyleSup">&#43;6</span><span class="elsevierStyleHsp" style=""></span>semanas de gestaci&#243;n que recibieron corticoides prenatales<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">29</span></a>&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">En este estudio&#44; en ambos grupos la incidencia de enfermedad de membrana hialina fue muy baja&#44; por lo que no se encontraron diferencias significativas&#46; Sin embargo&#44; tanto dicha patolog&#237;a como la administraci&#243;n de surfactante fueron m&#225;s frecuentes entre todos los PT que no recibieron corticoides prenatales&#44; consecuencia&#44; quiz&#225;s&#44; de su efecto en el desarrollo estructural y funcional del pulm&#243;n fetal&#44; incompleto a estas edades gestacionales&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">Son muy pocos los estudios acerca del probable efecto beneficioso de la administraci&#243;n prenatal de corticoides durante la prematuridad tard&#237;a&#46; Con el objetivo de dar una respuesta formal a esta cuesti&#243;n&#44; la <span class="elsevierStyleItalic">Maternal Fetal Medicine Units Network</span> est&#225; llevando a cabo un estudio multic&#233;ntrico prospectivo &#40;<span class="elsevierStyleItalic">Antenatal Late Preterm&#58; Randomized Placebo-Controlled Trial</span> &#91;ALPS&#93;&#41;&#44; evaluando la administraci&#243;n de corticoides prenatales a las mujeres con riesgo de parto pret&#233;rmino entre las 34 y 36<span class="elsevierStyleSup">&#43;6</span><span class="elsevierStyleHsp" style=""></span>semanas de gestaci&#243;n&#44; que finalizar&#225; en 2014<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">26</span></a>&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">La patolog&#237;a respiratoria no solo es el principal motivo de ingreso de los PT&#44; sino que tambi&#233;n se acompa&#241;a de otras complicaciones como la intolerancia digestiva asociada o no a la necesidad de t&#233;cnicas de soporte respiratorio&#44; sueroterapia y nutrici&#243;n parenteral&#46; Estos hallazgos se constatan es esta revisi&#243;n ya que&#44; al analizar los resultados&#44; se observa una reducci&#243;n significativa no solo del riesgo de enfermedades respiratorias agudas &#40;TTRN&#41; sino tambi&#233;n de presentar hipoglucemia&#44; intolerancia digestiva e ictericia&#44; y de la necesidad de t&#233;cnicas de soporte respiratorio &#40;oxigenoterapia&#44; CPAP nasal&#41;&#44; sueroterapia y fototerapia entre los que hab&#237;an recibido corticoides prenatales&#46; Por lo tanto&#44; y de acuerdo con nuestros resultados&#44; la extensi&#243;n de la administraci&#243;n prenatal de corticoides a los PT ser&#237;a una medida eficaz en la reducci&#243;n de la estancia hospitalaria y del consumo de recursos&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">El corte a las 34<span class="elsevierStyleHsp" style=""></span>semanas no deja de ser arbitrario&#44; porque aunque cl&#225;sicamente se considera que a esta edad gestacional se ha alcanzado la madurez arquitect&#243;nica y bioqu&#237;mica del pulm&#243;n&#44; despu&#233;s de analizar estos datos parece claro que no es as&#237;&#46; Al analizar la morbilidad seg&#250;n edad gestacional&#44; se encontr&#243; una reducci&#243;n significativa del riesgo a medida que se incrementa la edad gestacional&#59; sin embargo&#44; el efecto beneficioso de la corticoterapia prenatal se observa durante todo el periodo de la prematuridad tard&#237;a con independencia del peso al nacer&#46; Adem&#225;s&#44; los corticoides no solo influyen en la madurez estructural y funcional del pulm&#243;n fetal sino que tambi&#233;n poseen efectos extrapulmonares que contribuyen a la maduraci&#243;n de los diferentes &#243;rganos y sistemas<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">7&#44;30&#44;31</span></a>&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">Algunos estudios no apoyan la administraci&#243;n prenatal de corticoides&#46; En el estudio de Gyamfi-Bannerman et al&#46;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">32</span></a>&#44; observacional y multic&#233;ntrico&#44; no encontraron que la exposici&#243;n prenatal a los corticoides disminuyese la morbilidad respiratoria entre los PT&#46; Una limitaci&#243;n importante de este estudio es que ninguna de las mujeres recibi&#243; los corticoides durante las 34-36<span class="elsevierStyleHsp" style=""></span>semanas y que se desconoce cu&#225;ndo los recibieron&#44; pues su efecto se reduce con el paso del tiempo&#46; En este trabajo&#44; la mayor&#237;a de las mujeres recibieron un ciclo completo de corticoides antes de las 34<span class="elsevierStyleHsp" style=""></span>semanas &#40;la edad gestacional media de administraci&#243;n fue 31<span class="elsevierStyleSup">&#43;6</span><span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2<span class="elsevierStyleSup">&#43;2</span><span class="elsevierStyleHsp" style=""></span>semanas&#41;&#46; El tiempo transcurrido hasta el parto fueron 27&#44;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>15&#44;4 &#40;0-65&#41; d&#237;as&#44; y en el 12&#44;5&#37; de los casos el nacimiento tuvo lugar en los 7<span class="elsevierStyleHsp" style=""></span>d&#237;as siguientes a su administraci&#243;n&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">Otro estudio es un ensayo cl&#237;nico brasile&#241;o en el que se seleccionaron 320<span class="elsevierStyleHsp" style=""></span>mujeres entre 34 y 36<span class="elsevierStyleHsp" style=""></span>semanas&#44; a las que se administr&#243; un ciclo de corticoides o placebo&#46; La tasa de distr&#233;s respiratorio agudo fue muy baja en ambos grupos y la de TTRN&#44; similar y elevada entre ambos grupos&#44; por lo que el estudio no tuvo la potencia suficiente para detectar diferencias significativas<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">33</span></a>&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">Hasta el momento&#44; ning&#250;n ensayo cl&#237;nico ha evaluado los efectos adversos a largo plazo de la administraci&#243;n de corticoides prenatales durante el periodo de la prematuridad tard&#237;a&#46; Los m&#225;s descritos son la alteraci&#243;n del crecimiento y del neurodesarrollo&#46; En modelos animales se ha comprobado que los corticoides inducen la apoptosis y la muerte celular en el cerebro de los animales expuestos&#46; En la mayor&#237;a de los humanos el proceso de divisi&#243;n neuronal ya se ha completado a las 24<span class="elsevierStyleHsp" style=""></span>semanas de gestaci&#243;n&#44; pero no as&#237; el de los oligodendrocitos&#44; principales c&#233;lulas implicadas en la s&#237;ntesis de mielina&#44; cuyo crecimiento m&#225;s r&#225;pido ocurre entre las 34 y 36<span class="elsevierStyleHsp" style=""></span>semanas de gestaci&#243;n&#46; Esto har&#237;a a los PT m&#225;s vulnerables a los posibles efectos neurol&#243;gicos adversos de los corticoides prenatales que los m&#225;s prematuros<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">34</span></a>&#46; Un estudio sueco reciente sugiere que el efecto beneficioso de los corticoides prenatales se prolonga m&#225;s all&#225; de las 34<span class="elsevierStyleHsp" style=""></span>semanas y no parece incrementar el riesgo de efectos neurol&#243;gicos adversos<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">35</span></a>&#46; Todo ello justifica la necesidad de un seguimiento a largo plazo de este gran grupo de prematuros y m&#225;s estudios sobre los posibles efectos secundarios antes de confirmar su recomendaci&#243;n&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">Uno de los efectos adversos a corto plazo m&#225;s temido es la posibilidad de aumentar el riesgo de infecci&#243;n perinatal entre los PT&#44; riesgo incrementado debido a la inmadurez de su sistema inmune<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">36</span></a>&#44; y es por ello que valoramos y comparamos la incidencia de sepsis&#44; no observando diferencias entre ambos grupos&#46; Por lo tanto&#44; en este estudio los corticoides prenatales no aumentaron el riesgo de infecci&#243;n en los PT&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Conclusi&#243;n</span><p id="par0155" class="elsevierStylePara elsevierViewall">La morbilidad&#44; especialmente respiratoria&#44; de los PT de nuestro medio es significativamente inferior en los que recibieron corticoides prenatales&#44; sin efectos adversos a corto plazo&#46; Si se confirma la ausencia de efectos negativos a largo plazo&#44; podr&#237;a ser &#250;til prolongar la administraci&#243;n prenatal de corticoides m&#225;s all&#225; de las 34<span class="elsevierStyleHsp" style=""></span>semanas de gestaci&#243;n&#44; con la consiguiente reducci&#243;n significativa en las tasas de morbimortalidad&#44; duraci&#243;n de la estancia hospitalaria&#44; necesidad de ingreso en la UCIN&#44; utilizaci&#243;n de recursos e impacto econ&#243;mico-social relacionados con este grupo poblacional&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Conflicto de intereses</span><p id="par0160" class="elsevierStylePara elsevierViewall">Los autores declaran no tener ning&#250;n conflicto de intereses&#46;</p></span></span>"
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    "fechaRecibido" => "2013-11-06"
    "fechaAceptado" => "2014-01-27"
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          "palabras" => array:3 [
            0 => "Prematuro tard&#237;o"
            1 => "Corticoides prenatales"
            2 => "Prematuro"
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          "clase" => "keyword"
          "titulo" => "Keywords"
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            0 => "Late preterm infants"
            1 => "Antenatal corticosteroids"
            2 => "Premature"
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    "resumen" => array:2 [
      "es" => array:2 [
        "titulo" => "Resumen"
        "resumen" => "<span class="elsevierStyleSectionTitle" id="sect0010">Introducci&#243;n</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Se define al prematuro tard&#237;o como al reci&#233;n nacido de 34 a 36<span class="elsevierStyleHsp" style=""></span>semanas de gestaci&#243;n&#46; Este grupo presenta mayor riesgo de complicaciones que los nacidos a t&#233;rmino&#46; Sin embargo&#44; son pocas las intervenciones que se realizan para reducir esta mayor morbimortalidad&#46; La administraci&#243;n prenatal de corticoides podr&#237;a ser una medida preventiva eficaz&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0015">Objetivo</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Describir la morbilidad asociada a la prematuridad tard&#237;a y determinar si existen diferencias en los prematuros tard&#237;os que recibieron corticoides prenatales&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0020">Pacientes y m&#233;todos</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Estudio observacional prospectivo de los prematuros tard&#237;os nacidos en un hospital terciario desde octubre de 2011 a octubre de 2012&#46; Se clasificaron en 2<span class="elsevierStyleHsp" style=""></span>grupos&#44; seg&#250;n hubiesen o no recibido corticoides prenatales&#44; y se compararon las tasas de morbimortalidad entre los 2<span class="elsevierStyleHsp" style=""></span>grupos&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0025">Resultados</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">La tasa de prematuridad global fue del 8&#44;04&#37;&#44; de los cuales el 74&#44;4&#37; &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>247&#41; fueron prematuros tard&#237;os&#46; Precisaron ingreso el 63&#44;2&#37; &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>156&#41;&#44; suponiendo el 17&#37; del total de ingresados y el 20&#44;6&#37; de los ingresos en la unidad de cuidados intensivos neonatales&#46; Recibieron corticoides prenatales el 29&#44;6&#37; &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>73&#41;&#46; La incidencia de ingreso en neonatolog&#237;a y cuidados intensivos neonatales&#44; la presencia de taquipnea transitoria&#44; hipoglucemia&#44; intolerancia digestiva&#44; ictericia&#44; asistencia respiratoria en forma de presi&#243;n positiva continua en la v&#237;a respiratoria nasal&#44; oxigenoterapia&#44; sueroterapia y fototerapia fueron significativamente superiores &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41; en el grupo que no recibi&#243; corticoides prenatales&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0030">Conclusiones</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">La morbilidad de los prematuros tard&#237;os de nuestro medio es significativamente inferior en los que recibieron corticoides prenatales&#44; por lo que podr&#237;a ser &#250;til prolongar su administraci&#243;n m&#225;s all&#225; de las 34<span class="elsevierStyleHsp" style=""></span>semanas&#46;</p>"
      ]
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        "titulo" => "Abstract"
        "resumen" => "<span class="elsevierStyleSectionTitle" id="sect0040">Introduction</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Late preterm infants &#40;34-36<span class="elsevierStyleHsp" style=""></span>weeks gestation&#41; have a morbidity rate significantly higher than those born at term&#46; However&#44; few interventions have been undertaken to reduce this increased morbidity and mortality&#46; Antenatal corticosteroid administration could be an effective preventive measure&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0045">Objective</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">The aim of this study was to describe the morbidity associated with late prematurity in our institution&#44; and determine if there are differences between those who received antenatal corticosteroids&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0050">Patients and methods</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">A prospective observational study was conducted on late preterm infants born in a tertiary hospital from October 2011 until September 2012&#46; Two groups were formed according to whether or not they had received antenatal steroids&#46; The rates of morbidity and mortality for each of the groups were analysed and compared&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0055">Results</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">There was a total of 4127 live newborns during the study period&#44; of whom 3795 were term and 332 were preterm &#40;the overall prematurity rate was 8&#46;04&#37;&#41;&#46; There were 247 late preterm deliveries&#44; representing 6&#37; of live born infants&#44; and 74&#46;4&#37; of all premature infants&#46; Of late preterm infants&#44; 63&#46;2&#37; were admitted to the Neonatal Unit and 29&#46;6&#37; had received antenatal steroids&#46; The incidence of admission to the Neonatal Unit and Neonatal Intensive Care&#44; transient tachypnea&#44; need for respiratory support in the form of continuous positive pressure airway and oxygen therapy&#44; incidence of hypoglycemia&#44; feeding difficulty&#44; and jaundice requiring phototherapy were significantly higher &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;05&#41; in the late preterm group that did not receive antenatal steroids&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0060">Conclusions</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Our finding suggests that the administration of antenatal corticosteroids to patients at risk of 34-36<span class="elsevierStyleHsp" style=""></span>weeks delivery could significantly reduce the cost and acute morbidity associated with late preterm birth&#46;</p>"
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          "leyenda" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">APP&#58; amenaza de parto prematuro&#59; CIR&#58; crecimiento intrauterino retardado&#59; CPAP&#58; presi&#243;n positiva continua en la v&#237;a a&#233;rea&#59; EMH&#58; enfermedad de membrana hialina&#59; FIV&#58; fecundaci&#243;n in vitro&#59; HTA&#58; hipertensi&#243;n arterial&#59; HTP&#58; hipertensi&#243;n pulmonar&#59; NEC&#58; enterocolitis necrosante&#59; RPM&#58; rotura prematura de membranas&#59; TTRN&#58; taquipnea transitoria del reci&#233;n nacido&#59; VMC&#58; ventilaci&#243;n mec&#225;nica convencional&#46;</p>"
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                  \t\t\t\t" style="border-bottom: 2px solid black">Porcentaje &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>34 semanas&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>35 semanas&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>36 semanas&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Sexo&#58; varones</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>NEC&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1 &#40;0&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">111 &#40;64&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#60; 0&#44;0001&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0&#44;01&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>CPAP&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t">13 &#40;8&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Surfactante&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">&#60; 0&#44;0001&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">111 &#40;64&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">&#60; 0&#44;0001&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" style="border-bottom: 2px solid black">Variable&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" style="border-bottom: 2px solid black">n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" style="border-bottom: 2px solid black">p<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Morbilidad</span></td></tr><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Hipoglucemia&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Intolerancia digestiva&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Ictericia&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#60; 0&#44;0001&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Sepsis&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " colspan="5" align="char" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Necesidad de intervenci&#243;n</span></td></tr><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Oxigenoterapia&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>CPAP&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#60; 0&#44;0001&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Surfactante&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1 &#40;0&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#60; 0&#44;0001&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Sueroterapia&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">35 &#40;71&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">34 &#40;62&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">26 &#40;20&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#60; 0&#44;0001&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Nutrici&#243;n parenteral&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">20 &#40;41&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">8 &#40;12&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">8 &#40;6&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No CT &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13 &#40;14&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;1&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9 &#40;10&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">26 &#40;29&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">35 &#40;39&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">p<a class="elsevierStyleCrossRef" href="#tblfn0020"><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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;009&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;000&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;057&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60; 0&#44;0001&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60; 0&#44;0001&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab595741.png"
              ]
            ]
            1 => 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"><td 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" style="border-bottom: 2px solid black">Variable&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td 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" style="border-bottom: 2px solid black">Ox&#237;geno&#44; n &#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-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">CPAP&#44; n &#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-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">VMC&#44; n &#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-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Surfactante&#44; n &#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-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Sueroterapia&#44; n &#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-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Nutrici&#243;n parenteral&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="7" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">34-34</span><span class="elsevierStyleSup"><span class="elsevierStyleItalic">&#43;6</span></span><span class="elsevierStyleItalic">semanas &#40;n</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">&#61;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">49&#41;</span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">S&#237; CT &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>14&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;14&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;7&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;7&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 &#40;36&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No CT &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>35&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">23 &#40;66&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10 &#40;29&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10 &#40;29&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">28 &#40;80&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15 &#40;43&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">p<a class="elsevierStyleCrossRef" href="#tblfn0020"><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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;085&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;001&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;143&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;143&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;08&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;646&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="7" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">35-35</span><span class="elsevierStyleSup"><span class="elsevierStyleItalic">&#43;6</span></span><span class="elsevierStyleItalic">semanas &#40;n</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">&#61;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">65&#41;</span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">S&#237; CT &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>17&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;6&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;12&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No CT &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>48&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 &#40;13&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13 &#40;27&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;4&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;4&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">32 &#40;67&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;15&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">p<a class="elsevierStyleCrossRef" href="#tblfn0020"><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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;327&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;009&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;000&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;000&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60; 0&#44;0001&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;669&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>No CT &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>145&#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">38 &#40;26&#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">10&#40;7&#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">13&#40;9&#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">64&#40;44&#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">84 &#40;58&#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 &#40;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>p<a class="elsevierStyleCrossRef" href="#tblfn0030"><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">&#60; 0&#44;0001&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&#44;033&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&#44;011&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; 0&#44;0001&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; 0&#44;0001&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&#44;668&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab595743.png"
              ]
            ]
            1 => 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"><td 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" style="border-bottom: 2px solid black">Variable&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td 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" style="border-bottom: 2px solid black">Ox&#237;geno&#44; n &#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-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">CPAP&#44; n &#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-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">VMC&#44; n &#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-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Surfactante&#44; n &#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-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Sueroterapia&#44; n &#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-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Nutrici&#243;n parenteral&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="7" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">&#60; 2&#46;000 g &#40;n</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">&#61;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">36&#41;</span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>S&#237; CT &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>7&#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&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">2 &#40;29&#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 &#40;14&#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 &#40;14&#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">3 &#40;43&#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">6 &#40;86&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>No CT &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>29&#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">2 &#40;7&#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">10 &#40;34&#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">3 &#40;10&#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">3 &#40;10&#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">26 &#40;90&#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">18 &#40;62&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>p<a class="elsevierStyleCrossRef" href="#tblfn0030"><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">1&#44;000&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&#44;000&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&#44;000&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&#44;000&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&#44;016&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&#44;384&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="7" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="7" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">&#62; 2&#46;000 g &#40;n</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">&#61;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">211&#41;</span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>S&#237; CT &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>66&#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&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">2 &#40;3&#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&#40;2&#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&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 &#40;11&#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&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>No CT &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>145&#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">14 &#40;10&#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">32 &#40;22&#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 &#40;8&#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">10 &#40;7&#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">59 &#40;41&#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 &#40;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>p<a class="elsevierStyleCrossRef" href="#tblfn0030"><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&#44;006&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; 0&#44;0001&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&#44;068&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&#44;033&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; 0&#44;0001&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&#44;020&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab595746.png"
              ]
            ]
          ]
          "notaPie" => array:1 [
            0 => array:3 [
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Original
Corticoterapia prenatal y morbimortalidad del prematuro tardío: estudio prospectivo
Antenatal corticosteroid therapy and late preterm infant morbidity and mortality
I.M. Gázquez Serranoa,
Autor para correspondencia
isabelgazquezserrano@gmail.com
nebito82@hotmail.com

Autor para correspondencia.
, A. Arroyos Planaa, O. Díaz Moralesb, C. Herráiz Pereaa, A. Holgueras Bragadoa
a Servicio de Neonatología, Hospital Virgen de la Salud, Toledo, España
b Servicio de Pediatría, Hospital de Antequera, Antequera, Málaga, España
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se analizaron todos estos par&#225;metros para cada edad gestacional y peso al nacer&#44; con el fin de conocer si exist&#237;an diferencias significativas entre los que recibieron corticoides y los que no&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Se realiz&#243; un estudio comparativo de la frecuencia de cada uno de los datos analizados entre los 2<span class="elsevierStyleHsp" style=""></span>grupos&#46; Como herramienta estad&#237;stica se utiliz&#243; el programa SPSS versi&#243;n 18&#46;0 para Windows&#46; Las variables cuantitativas se expresan como media<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>desviaci&#243;n est&#225;ndar y valores m&#225;ximos y m&#237;nimos&#46; Las variables cualitativas se expresan como frecuencias absolutas &#40;n&#41; y frecuencias relativas &#40;&#37;&#41;&#46; La comparaci&#243;n entre los grupos se realiz&#243; mediante pruebas chi-cuadrado para tablas de contingencia y el estad&#237;stico exacto de Fisher cuando alguna frecuencia esperada fue inferior a 5&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Resultados</span><p id="par0040" class="elsevierStylePara elsevierViewall">En el periodo estudiado &#40;1 de octubre de 2011 a 30 de septiembre de 2012&#41; nacieron 4&#46;127<span class="elsevierStyleHsp" style=""></span>RN vivos&#44; de los cuales 3&#46;795 fueron a t&#233;rmino y 332 pret&#233;rmino&#44; con una tasa de prematuridad global anual del 8&#44;04&#37;&#46; De estos &#250;ltimos&#44; 247 fueron PT&#44; poblaci&#243;n que supuso el 6&#37; de RN vivos y el 74&#44;4&#37; de todos los prematuros&#46; Ingresaron en la unidad de neonatolog&#237;a el 63&#44;2&#37; de los PT &#40;17&#37; del total de RN ingresados&#41;&#44; siendo su estancia media de 14&#44;70<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>11&#44;4 &#40;3-90&#41; d&#237;as&#46; De ellos&#44; el 28&#44;2&#37; precis&#243; ingreso en la UCIN con una estancia media de 7&#44;11<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>10&#44;4 &#40;1-70&#41; d&#237;as&#44; suponiendo el 20&#44;6&#37; del total de RN ingresados en la UCIN&#46; La tasa de mortalidad neonatal para los PT fue cero&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">La <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a> describe las caracter&#237;sticas generales&#44; los antecedentes obst&#233;tricos y perinatales y la morbilidad global en el periodo neonatal de los PT incluidos en el estudio&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0050" class="elsevierStylePara elsevierViewall">Los PT estudiados &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>247&#41; se dividieron en 2<span class="elsevierStyleHsp" style=""></span>grupos seg&#250;n la administraci&#243;n prenatal de corticoides&#46; Recibieron corticoides prenatales el 29&#44;6&#37; &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>73&#41;&#44; de los cuales el 98&#44;6&#37; &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>72&#41; recibieron un curso completo &#40;2<span class="elsevierStyleHsp" style=""></span>dosis de betametasona cada 24<span class="elsevierStyleHsp" style=""></span>h antes del parto&#41;&#46; La edad gestacional media de administraci&#243;n fueron 31<span class="elsevierStyleSup">&#43;6</span><span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2<span class="elsevierStyleSup">&#43;2</span> &#40;25-34<span class="elsevierStyleSup">&#43;1</span>&#41; semanas&#46; El tiempo transcurrido hasta el parto fue de 27&#44;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>15&#44;4 &#40;0-65&#41; d&#237;as&#46; En el 12&#44;5&#37; de las mujeres que recibieron un ciclo completo&#44; el parto tuvo lugar en los 7<span class="elsevierStyleHsp" style=""></span>d&#237;as siguientes a su administraci&#243;n&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">No hubo diferencias significativas entre ambos grupos en la mayor&#237;a de los antecedentes y resultados perinatales &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0060" class="elsevierStylePara elsevierViewall">El resultado del estudio comparativo entre ambos grupos acerca de la morbilidad neonatal y las necesidades de intervenci&#243;n se muestra en la <a class="elsevierStyleCrossRef" href="#tbl0015">tabla 3</a>&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0065" class="elsevierStylePara elsevierViewall">La tasa de ingreso en neonatolog&#237;a fue significativamente superior &#40;74&#37; frente al 38&#37;&#41; en los PT que no recibieron corticoides prenatales&#46; La necesidad de ingreso en la UCIN tambi&#233;n fue significativamente superior en este grupo &#40;22&#37; frente al 8&#37;&#41;&#46; Todas las patolog&#237;as asociadas a la prematuridad tard&#237;a fueron menos frecuentes en el grupo que recibi&#243; corticoides prenatales&#44; siendo estas diferencias significativas para la TTRN&#44; la presencia de hipoglucemia&#44; intolerancia digestiva e ictericia que precisa fototerapia&#46; Asimismo&#44; la necesidad de t&#233;cnicas de asistencia respiratoria en forma de oxigenoterapia y CPAP nasal y los requerimientos de sueroterapia y nutrici&#243;n parenteral fueron significativamente superiores en el grupo de PT que no recibieron corticoides prenatales&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">En el an&#225;lisis comparativo seg&#250;n edad gestacional se observan diferencias significativas semana a semana&#44; existiendo un evidente descenso a medida que se incrementa la edad gestacional &#40;<a class="elsevierStyleCrossRef" href="#tbl0020">tabla 4</a>&#41;&#46; Todas las patolog&#237;as y necesidades de intervenci&#243;n fueron menos frecuentes en los que recibieron corticoides prenatales a cualquier edad gestacional&#44; siendo de nuevo esta disminuci&#243;n significativa para la TTRN&#44; la intolerancia digestiva&#44; la ictericia y la necesidad de fototerapia&#44; sueroterapia y CPAP nasal &#40;<a class="elsevierStyleCrossRef" href="#tbl0025">tabla 5</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia><elsevierMultimedia ident="tbl0025"></elsevierMultimedia><p id="par0075" class="elsevierStylePara elsevierViewall">Por &#250;ltimo&#44; al analizar estos datos seg&#250;n el peso al nacer se corrobora que a menor peso hay mayores riesgos&#44; especialmente para los problemas de alimentaci&#243;n y las necesidades de sueroterapia y nutrici&#243;n parenteral&#44; que fueron significativamente m&#225;s frecuentes &#40;<a class="elsevierStyleCrossRef" href="#tbl0030">tabla 6</a>&#41;&#46; La morbilidad fue mayor entre todos los PT que no recibieron corticoterapia prenatal&#44; aunque estas diferencias solo fueron significativas para los &#62;<span class="elsevierStyleHsp" style=""></span>2&#46;000<span class="elsevierStyleHsp" style=""></span>g&#44; por constituir el grupo m&#225;s frecuente &#40;<a class="elsevierStyleCrossRef" href="#tbl0035">tabla 7</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0030"></elsevierMultimedia><elsevierMultimedia ident="tbl0035"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Discusi&#243;n</span><p id="par0080" class="elsevierStylePara elsevierViewall">De manera similar a la bibliograf&#237;a revisada&#44; la tasa de prematuridad global en este centro durante el periodo de tiempo estudiado fue del 8&#44;04&#37;&#46; Dentro de este grupo&#44; el 74&#44;4&#37; pertenecieron al subgrupo de PT&#46; Estos datos coinciden con los publicados en la mayor&#237;a de pa&#237;ses desarrollados donde&#44; adem&#225;s&#44; se describe una tendencia creciente<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;11&#44;12</span></a>&#46; Entre las causas implicadas se encuentran la edad materna avanzada en prim&#237;paras&#44; el embarazo m&#250;ltiple&#44; las t&#233;cnicas de reproducci&#243;n asistida y el aumento de indicaciones m&#233;dicas para la inducci&#243;n del parto o ces&#225;rea programada&#46; En este estudio el 42&#44;5&#37; de las madres ten&#237;an &#8805;<span class="elsevierStyleHsp" style=""></span>35<span class="elsevierStyleHsp" style=""></span>a&#241;os&#59; eran prim&#237;paras el 46&#44;6&#37;&#59; el 7&#44;7&#37; de los embarazos se consiguieron mediante t&#233;cnicas de reproducci&#243;n asistida&#59; el 24&#44;1&#37; fueron gestaciones m&#250;ltiples&#44; y en el 41&#44;7&#37; el parto fue inducido por indicaci&#243;n materna o fetal&#44; cifras que coinciden con las reflejadas en la literatura<a class="elsevierStyleCrossRefs" href="#bib0065"><span class="elsevierStyleSup">13-17</span></a>&#46; Estos resultados no resultan extra&#241;os si tenemos en cuenta que todos estos factores se encuentran relacionados entre s&#237;&#46; La edad materna avanzada se asocia con un mayor riesgo de complicaciones obst&#233;tricas&#44; que en muchas ocasiones son la indicaci&#243;n para la finalizaci&#243;n de la gestaci&#243;n&#44; y tambi&#233;n es m&#225;s frecuente la necesidad de t&#233;cnicas de reproducci&#243;n asistida que aumentan la probabilidad de embarazo m&#250;ltiple&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">En este trabajo&#44; el 63&#44;2&#37; de los PT ingresaron en la unidad de neonatolog&#237;a y el 28&#44;2&#37; precisaron cuidados intensivos neonatales&#44; generando un importante n&#250;mero de estancias hospitalarias al constituir el grupo m&#225;s frecuente de prematuros&#46; Representan el 17&#37; del total de RN ingresados y el 20&#44;6&#37; del total de ingresos en la UCIN&#46; En este centro los criterios generales de ingreso son todos los RN de &#8804;<span class="elsevierStyleHsp" style=""></span>34<span class="elsevierStyleHsp" style=""></span>semanas de gestaci&#243;n y los RN<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>34<span class="elsevierStyleHsp" style=""></span>semanas con peso al nacer &#60;<span class="elsevierStyleHsp" style=""></span>2&#46;300<span class="elsevierStyleHsp" style=""></span>g o con cualquier patolog&#237;a que requiera monitorizaci&#243;n y&#47;o tratamiento&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">Durante la &#250;ltima d&#233;cada son numerosas las investigaciones que confirman&#44; de manera repetida&#44; que presentan una morbilidad mayor que los nacidos a t&#233;rmino debido a su inmadurez&#46; Los PT estudiados presentaron una frecuencia de enfermedades respiratorias&#44; ictericia&#44; hipoglucemia&#44; dificultades en la alimentaci&#243;n y sepsis similares a las descritas en la literatura<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4&#44;18-22</span></a>&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">La inducci&#243;n farmacol&#243;gica de la madurez pulmonar fetal con corticoides ha sido la intervenci&#243;n que m&#225;s ha cambiado el pron&#243;stico de los RN prematuros&#46; Como resultado&#44; las Sociedades Americana y Espa&#241;ola de Obstetricia y Ginecolog&#237;a recomiendan la administraci&#243;n prenatal de corticoides a gestantes con riesgo de parto pret&#233;rmino entre las 24 y las 34<span class="elsevierStyleHsp" style=""></span>semanas de gestaci&#243;n&#44; con el objetivo de reducir la incidencia de distr&#233;s respiratorio agudo&#44; hemorragia intraventricular&#44; enterocolitis necrosante y&#47;o muerte neonatal<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">23</span></a>&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">En este trabajo recibieron corticoides prenatales el 29&#44;6&#37; &#40;73&#41; de los PT&#44; siendo su tasa de ingreso tanto en la unidad neonatal &#40;74&#37; vs&#46; 38&#37;&#41; como en la UCIN &#40;22&#37; vs&#46; 8&#37;&#41; significativamente superior en los que no los recibieron&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">Dentro de la morbilidad asociada a la prematuridad tard&#237;a&#44; la patolog&#237;a respiratoria es una de las m&#225;s frecuentes&#46; En este estudio&#44; el 27&#44;1&#37; de los PT presentaron complicaciones respiratorias&#44; siendo la TTRN el diagn&#243;stico m&#225;s frecuente &#40;20&#44;2&#37;&#41;&#46; Esta alta incidencia podr&#237;a explicarse por la existencia de alteraciones o retraso en la eliminaci&#243;n del l&#237;quido pulmonar fetal tras el nacimiento&#46; Varias investigaciones proponen el transporte de sodio a trav&#233;s del epitelio alveolar como el principal mecanismo implicado en la reabsorci&#243;n del l&#237;quido pulmonar fetal&#44; actividad que se desarrolla a medida que avanza la edad gestacional&#44; siendo especialmente importante en las &#250;ltimas semanas de gestaci&#243;n&#46; En los PT&#44; el menor n&#250;mero as&#237; como la inmadurez de los mecanismos transportadores de sodio podr&#237;an estar implicadas en la patog&#233;nesis de la TTRN<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">24</span></a>&#46; En el grupo de PT que no recibieron corticoides la incidencia de TTRN fue significativamente superior a la encontrada en el grupo que s&#237; los recibi&#243;&#58; 28&#37; versus 2&#44;7&#37; &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;0001&#41;&#46; Esta diferencia parece tener su explicaci&#243;n en que solamente los glucocorticoides parecen estimular la s&#237;ntesis y la actividad de los canales de sodio del epitelio alveolar&#44; incrementando as&#237; la reabsorci&#243;n de l&#237;quido pulmonar&#46; Se sabe que durante el parto vaginal espont&#225;neo a t&#233;rmino se produce un aumento de los esteroides end&#243;genos y catecolaminas&#44; cambios hormonales necesarios para la maduraci&#243;n y preparaci&#243;n del feto para una transici&#243;n neonatal correcta&#46; Esta ser&#237;a la raz&#243;n por la que en los PT que no han recibido corticoides prenatales la presencia de TTRN se ve incrementada&#44; m&#225;s a&#250;n en los nacidos por ces&#225;rea&#44; circunstancia que&#44; como hemos referido anteriormente&#44; es m&#225;s frecuente en este grupo &#40;32&#44;4&#37;&#41;<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">25</span></a>&#46; En este trabajo&#44; los casos de TTRN nacieron en la misma proporci&#243;n mediante ces&#225;rea y por v&#237;a vaginal&#46; En cada grupo&#44; solo uno recibi&#243; corticoides antenatales&#46; Seg&#250;n estos resultados&#44; la corticoterapia prenatal disminuye el riesgo de TTRN&#44; sea cual sea el mecanismo del parto&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">El inter&#233;s del tema radica en que dicha patolog&#237;a es muy frecuente y el principal motivo de ingreso de los PT&#46; A la hora de decidir a qu&#233; edad gestacional se recomienda la administraci&#243;n prenatal de corticoides no solo influye la frecuencia de la enfermedad &#40;los PT presentan menos morbilidad respiratoria que los prematuros de una edad gestacional inferior&#41;&#44; sino tambi&#233;n el n&#250;mero total de pacientes que se ver&#237;an beneficiados&#46; Como ya hemos referido&#44; los PT constituyen el grupo m&#225;s frecuente de prematuros&#44; por lo que se reducir&#237;a el n&#250;mero total de pacientes que ingresar&#237;an en la UCIN&#44; lo que supone un menor coste socioecon&#243;mico<a class="elsevierStyleCrossRefs" href="#bib0130"><span class="elsevierStyleSup">26-28</span></a>&#46; En este mismo sentido&#44; la Cochrane apoya la administraci&#243;n prenatal de corticoides hasta las 34<span class="elsevierStyleSup">&#43;6</span><span class="elsevierStyleHsp" style=""></span>semanas de gestaci&#243;n&#46; Esta recomendaci&#243;n se basa en la disminuci&#243;n de la aparici&#243;n de s&#237;ndrome de distr&#233;s respiratorio en el subgrupo de prematuros entre 33 y 34<span class="elsevierStyleSup">&#43;6</span><span class="elsevierStyleHsp" style=""></span>semanas de gestaci&#243;n que recibieron corticoides prenatales<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">29</span></a>&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">En este estudio&#44; en ambos grupos la incidencia de enfermedad de membrana hialina fue muy baja&#44; por lo que no se encontraron diferencias significativas&#46; Sin embargo&#44; tanto dicha patolog&#237;a como la administraci&#243;n de surfactante fueron m&#225;s frecuentes entre todos los PT que no recibieron corticoides prenatales&#44; consecuencia&#44; quiz&#225;s&#44; de su efecto en el desarrollo estructural y funcional del pulm&#243;n fetal&#44; incompleto a estas edades gestacionales&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">Son muy pocos los estudios acerca del probable efecto beneficioso de la administraci&#243;n prenatal de corticoides durante la prematuridad tard&#237;a&#46; Con el objetivo de dar una respuesta formal a esta cuesti&#243;n&#44; la <span class="elsevierStyleItalic">Maternal Fetal Medicine Units Network</span> est&#225; llevando a cabo un estudio multic&#233;ntrico prospectivo &#40;<span class="elsevierStyleItalic">Antenatal Late Preterm&#58; Randomized Placebo-Controlled Trial</span> &#91;ALPS&#93;&#41;&#44; evaluando la administraci&#243;n de corticoides prenatales a las mujeres con riesgo de parto pret&#233;rmino entre las 34 y 36<span class="elsevierStyleSup">&#43;6</span><span class="elsevierStyleHsp" style=""></span>semanas de gestaci&#243;n&#44; que finalizar&#225; en 2014<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">26</span></a>&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">La patolog&#237;a respiratoria no solo es el principal motivo de ingreso de los PT&#44; sino que tambi&#233;n se acompa&#241;a de otras complicaciones como la intolerancia digestiva asociada o no a la necesidad de t&#233;cnicas de soporte respiratorio&#44; sueroterapia y nutrici&#243;n parenteral&#46; Estos hallazgos se constatan es esta revisi&#243;n ya que&#44; al analizar los resultados&#44; se observa una reducci&#243;n significativa no solo del riesgo de enfermedades respiratorias agudas &#40;TTRN&#41; sino tambi&#233;n de presentar hipoglucemia&#44; intolerancia digestiva e ictericia&#44; y de la necesidad de t&#233;cnicas de soporte respiratorio &#40;oxigenoterapia&#44; CPAP nasal&#41;&#44; sueroterapia y fototerapia entre los que hab&#237;an recibido corticoides prenatales&#46; Por lo tanto&#44; y de acuerdo con nuestros resultados&#44; la extensi&#243;n de la administraci&#243;n prenatal de corticoides a los PT ser&#237;a una medida eficaz en la reducci&#243;n de la estancia hospitalaria y del consumo de recursos&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">El corte a las 34<span class="elsevierStyleHsp" style=""></span>semanas no deja de ser arbitrario&#44; porque aunque cl&#225;sicamente se considera que a esta edad gestacional se ha alcanzado la madurez arquitect&#243;nica y bioqu&#237;mica del pulm&#243;n&#44; despu&#233;s de analizar estos datos parece claro que no es as&#237;&#46; Al analizar la morbilidad seg&#250;n edad gestacional&#44; se encontr&#243; una reducci&#243;n significativa del riesgo a medida que se incrementa la edad gestacional&#59; sin embargo&#44; el efecto beneficioso de la corticoterapia prenatal se observa durante todo el periodo de la prematuridad tard&#237;a con independencia del peso al nacer&#46; Adem&#225;s&#44; los corticoides no solo influyen en la madurez estructural y funcional del pulm&#243;n fetal sino que tambi&#233;n poseen efectos extrapulmonares que contribuyen a la maduraci&#243;n de los diferentes &#243;rganos y sistemas<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">7&#44;30&#44;31</span></a>&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">Algunos estudios no apoyan la administraci&#243;n prenatal de corticoides&#46; En el estudio de Gyamfi-Bannerman et al&#46;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">32</span></a>&#44; observacional y multic&#233;ntrico&#44; no encontraron que la exposici&#243;n prenatal a los corticoides disminuyese la morbilidad respiratoria entre los PT&#46; Una limitaci&#243;n importante de este estudio es que ninguna de las mujeres recibi&#243; los corticoides durante las 34-36<span class="elsevierStyleHsp" style=""></span>semanas y que se desconoce cu&#225;ndo los recibieron&#44; pues su efecto se reduce con el paso del tiempo&#46; En este trabajo&#44; la mayor&#237;a de las mujeres recibieron un ciclo completo de corticoides antes de las 34<span class="elsevierStyleHsp" style=""></span>semanas &#40;la edad gestacional media de administraci&#243;n fue 31<span class="elsevierStyleSup">&#43;6</span><span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2<span class="elsevierStyleSup">&#43;2</span><span class="elsevierStyleHsp" style=""></span>semanas&#41;&#46; El tiempo transcurrido hasta el parto fueron 27&#44;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>15&#44;4 &#40;0-65&#41; d&#237;as&#44; y en el 12&#44;5&#37; de los casos el nacimiento tuvo lugar en los 7<span class="elsevierStyleHsp" style=""></span>d&#237;as siguientes a su administraci&#243;n&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">Otro estudio es un ensayo cl&#237;nico brasile&#241;o en el que se seleccionaron 320<span class="elsevierStyleHsp" style=""></span>mujeres entre 34 y 36<span class="elsevierStyleHsp" style=""></span>semanas&#44; a las que se administr&#243; un ciclo de corticoides o placebo&#46; La tasa de distr&#233;s respiratorio agudo fue muy baja en ambos grupos y la de TTRN&#44; similar y elevada entre ambos grupos&#44; por lo que el estudio no tuvo la potencia suficiente para detectar diferencias significativas<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">33</span></a>&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">Hasta el momento&#44; ning&#250;n ensayo cl&#237;nico ha evaluado los efectos adversos a largo plazo de la administraci&#243;n de corticoides prenatales durante el periodo de la prematuridad tard&#237;a&#46; Los m&#225;s descritos son la alteraci&#243;n del crecimiento y del neurodesarrollo&#46; En modelos animales se ha comprobado que los corticoides inducen la apoptosis y la muerte celular en el cerebro de los animales expuestos&#46; En la mayor&#237;a de los humanos el proceso de divisi&#243;n neuronal ya se ha completado a las 24<span class="elsevierStyleHsp" style=""></span>semanas de gestaci&#243;n&#44; pero no as&#237; el de los oligodendrocitos&#44; principales c&#233;lulas implicadas en la s&#237;ntesis de mielina&#44; cuyo crecimiento m&#225;s r&#225;pido ocurre entre las 34 y 36<span class="elsevierStyleHsp" style=""></span>semanas de gestaci&#243;n&#46; Esto har&#237;a a los PT m&#225;s vulnerables a los posibles efectos neurol&#243;gicos adversos de los corticoides prenatales que los m&#225;s prematuros<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">34</span></a>&#46; Un estudio sueco reciente sugiere que el efecto beneficioso de los corticoides prenatales se prolonga m&#225;s all&#225; de las 34<span class="elsevierStyleHsp" style=""></span>semanas y no parece incrementar el riesgo de efectos neurol&#243;gicos adversos<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">35</span></a>&#46; Todo ello justifica la necesidad de un seguimiento a largo plazo de este gran grupo de prematuros y m&#225;s estudios sobre los posibles efectos secundarios antes de confirmar su recomendaci&#243;n&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">Uno de los efectos adversos a corto plazo m&#225;s temido es la posibilidad de aumentar el riesgo de infecci&#243;n perinatal entre los PT&#44; riesgo incrementado debido a la inmadurez de su sistema inmune<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">36</span></a>&#44; y es por ello que valoramos y comparamos la incidencia de sepsis&#44; no observando diferencias entre ambos grupos&#46; Por lo tanto&#44; en este estudio los corticoides prenatales no aumentaron el riesgo de infecci&#243;n en los PT&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Conclusi&#243;n</span><p id="par0155" class="elsevierStylePara elsevierViewall">La morbilidad&#44; especialmente respiratoria&#44; de los PT de nuestro medio es significativamente inferior en los que recibieron corticoides prenatales&#44; sin efectos adversos a corto plazo&#46; Si se confirma la ausencia de efectos negativos a largo plazo&#44; podr&#237;a ser &#250;til prolongar la administraci&#243;n prenatal de corticoides m&#225;s all&#225; de las 34<span class="elsevierStyleHsp" style=""></span>semanas de gestaci&#243;n&#44; con la consiguiente reducci&#243;n significativa en las tasas de morbimortalidad&#44; duraci&#243;n de la estancia hospitalaria&#44; necesidad de ingreso en la UCIN&#44; utilizaci&#243;n de recursos e impacto econ&#243;mico-social relacionados con este grupo poblacional&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Conflicto de intereses</span><p id="par0160" class="elsevierStylePara elsevierViewall">Los autores declaran no tener ning&#250;n conflicto de intereses&#46;</p></span></span>"
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            0 => "Prematuro tard&#237;o"
            1 => "Corticoides prenatales"
            2 => "Prematuro"
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          "clase" => "keyword"
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            0 => "Late preterm infants"
            1 => "Antenatal corticosteroids"
            2 => "Premature"
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    "resumen" => array:2 [
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        "titulo" => "Resumen"
        "resumen" => "<span class="elsevierStyleSectionTitle" id="sect0010">Introducci&#243;n</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Se define al prematuro tard&#237;o como al reci&#233;n nacido de 34 a 36<span class="elsevierStyleHsp" style=""></span>semanas de gestaci&#243;n&#46; Este grupo presenta mayor riesgo de complicaciones que los nacidos a t&#233;rmino&#46; Sin embargo&#44; son pocas las intervenciones que se realizan para reducir esta mayor morbimortalidad&#46; La administraci&#243;n prenatal de corticoides podr&#237;a ser una medida preventiva eficaz&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0015">Objetivo</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Describir la morbilidad asociada a la prematuridad tard&#237;a y determinar si existen diferencias en los prematuros tard&#237;os que recibieron corticoides prenatales&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0020">Pacientes y m&#233;todos</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Estudio observacional prospectivo de los prematuros tard&#237;os nacidos en un hospital terciario desde octubre de 2011 a octubre de 2012&#46; Se clasificaron en 2<span class="elsevierStyleHsp" style=""></span>grupos&#44; seg&#250;n hubiesen o no recibido corticoides prenatales&#44; y se compararon las tasas de morbimortalidad entre los 2<span class="elsevierStyleHsp" style=""></span>grupos&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0025">Resultados</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">La tasa de prematuridad global fue del 8&#44;04&#37;&#44; de los cuales el 74&#44;4&#37; &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>247&#41; fueron prematuros tard&#237;os&#46; Precisaron ingreso el 63&#44;2&#37; &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>156&#41;&#44; suponiendo el 17&#37; del total de ingresados y el 20&#44;6&#37; de los ingresos en la unidad de cuidados intensivos neonatales&#46; Recibieron corticoides prenatales el 29&#44;6&#37; &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>73&#41;&#46; La incidencia de ingreso en neonatolog&#237;a y cuidados intensivos neonatales&#44; la presencia de taquipnea transitoria&#44; hipoglucemia&#44; intolerancia digestiva&#44; ictericia&#44; asistencia respiratoria en forma de presi&#243;n positiva continua en la v&#237;a respiratoria nasal&#44; oxigenoterapia&#44; sueroterapia y fototerapia fueron significativamente superiores &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41; en el grupo que no recibi&#243; corticoides prenatales&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0030">Conclusiones</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">La morbilidad de los prematuros tard&#237;os de nuestro medio es significativamente inferior en los que recibieron corticoides prenatales&#44; por lo que podr&#237;a ser &#250;til prolongar su administraci&#243;n m&#225;s all&#225; de las 34<span class="elsevierStyleHsp" style=""></span>semanas&#46;</p>"
      ]
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        "titulo" => "Abstract"
        "resumen" => "<span class="elsevierStyleSectionTitle" id="sect0040">Introduction</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Late preterm infants &#40;34-36<span class="elsevierStyleHsp" style=""></span>weeks gestation&#41; have a morbidity rate significantly higher than those born at term&#46; However&#44; few interventions have been undertaken to reduce this increased morbidity and mortality&#46; Antenatal corticosteroid administration could be an effective preventive measure&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0045">Objective</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">The aim of this study was to describe the morbidity associated with late prematurity in our institution&#44; and determine if there are differences between those who received antenatal corticosteroids&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0050">Patients and methods</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">A prospective observational study was conducted on late preterm infants born in a tertiary hospital from October 2011 until September 2012&#46; Two groups were formed according to whether or not they had received antenatal steroids&#46; The rates of morbidity and mortality for each of the groups were analysed and compared&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0055">Results</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">There was a total of 4127 live newborns during the study period&#44; of whom 3795 were term and 332 were preterm &#40;the overall prematurity rate was 8&#46;04&#37;&#41;&#46; There were 247 late preterm deliveries&#44; representing 6&#37; of live born infants&#44; and 74&#46;4&#37; of all premature infants&#46; Of late preterm infants&#44; 63&#46;2&#37; were admitted to the Neonatal Unit and 29&#46;6&#37; had received antenatal steroids&#46; The incidence of admission to the Neonatal Unit and Neonatal Intensive Care&#44; transient tachypnea&#44; need for respiratory support in the form of continuous positive pressure airway and oxygen therapy&#44; incidence of hypoglycemia&#44; feeding difficulty&#44; and jaundice requiring phototherapy were significantly higher &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;05&#41; in the late preterm group that did not receive antenatal steroids&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0060">Conclusions</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Our finding suggests that the administration of antenatal corticosteroids to patients at risk of 34-36<span class="elsevierStyleHsp" style=""></span>weeks delivery could significantly reduce the cost and acute morbidity associated with late preterm birth&#46;</p>"
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          "leyenda" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">APP&#58; amenaza de parto prematuro&#59; CIR&#58; crecimiento intrauterino retardado&#59; CPAP&#58; presi&#243;n positiva continua en la v&#237;a a&#233;rea&#59; EMH&#58; enfermedad de membrana hialina&#59; FIV&#58; fecundaci&#243;n in vitro&#59; HTA&#58; hipertensi&#243;n arterial&#59; HTP&#58; hipertensi&#243;n pulmonar&#59; NEC&#58; enterocolitis necrosante&#59; RPM&#58; rotura prematura de membranas&#59; TTRN&#58; taquipnea transitoria del reci&#233;n nacido&#59; VMC&#58; ventilaci&#243;n mec&#225;nica convencional&#46;</p>"
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                  \t\t\t\t" style="border-bottom: 2px solid black">Porcentaje &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Edad gestacional</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>36 semanas&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Sexo&#58; varones</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td 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" style="border-bottom: 2px solid black">Variable&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td 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" style="border-bottom: 2px solid black">TTRN&#44; n &#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-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">EMH&#44; n &#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-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Hipoglucemia&#44; n &#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-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Intolerancia digestive&#44; n &#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-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Ictericia&#44; n &#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-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Sepsis&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="7" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">34-34</span><span class="elsevierStyleSup"><span class="elsevierStyleItalic">&#43;6</span></span><span class="elsevierStyleItalic">semanas &#40;n</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">&#61;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">49&#41;</span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>S&#237; CT &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>14&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;7&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;7&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10 &#40;71&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10 &#40;71&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>No CT &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>35&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">19 &#40;54&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9 &#40;26&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 &#40;14&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">34 &#40;97&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">34 &#40;97&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>p<a class="elsevierStyleCrossRef" href="#tblfn0020"><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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;002&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;244&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;303&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;019&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;019&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;548&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="7" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="7" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">35-35</span><span class="elsevierStyleSup"><span class="elsevierStyleItalic">&#43;6</span></span><span class="elsevierStyleItalic">semanas &#40;n</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">&#61;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">65&#41;</span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">S&#237; CT &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>17&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;6&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;18&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 &#40;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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No CT &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>48&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16 &#40;33&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;4&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 &#40;10&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">32 &#40;67&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">42 &#40;88&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">p<a class="elsevierStyleCrossRef" href="#tblfn0020"><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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;029&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;000&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;315&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60; 0&#44;0001&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60; 0&#44;0001&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="7" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="7" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">36-36</span><span class="elsevierStyleSup"><span class="elsevierStyleItalic">&#43;6</span></span><span class="elsevierStyleItalic">semanas &#40;n</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">&#61;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">133&#41;</span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">S&#237; CT &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>42&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;1&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;2&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No CT &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13 &#40;14&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;1&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9 &#40;10&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">26 &#40;29&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">35 &#40;39&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">p<a class="elsevierStyleCrossRef" href="#tblfn0020"><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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;009&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;000&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;057&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60; 0&#44;0001&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60; 0&#44;0001&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab595741.png"
              ]
            ]
            1 => 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"><td 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" style="border-bottom: 2px solid black">Variable&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td 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" style="border-bottom: 2px solid black">Ox&#237;geno&#44; n &#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-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">CPAP&#44; n &#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-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">VMC&#44; n &#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-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Surfactante&#44; n &#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-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Sueroterapia&#44; n &#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-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Nutrici&#243;n parenteral&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="7" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">34-34</span><span class="elsevierStyleSup"><span class="elsevierStyleItalic">&#43;6</span></span><span class="elsevierStyleItalic">semanas &#40;n</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">&#61;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">49&#41;</span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">S&#237; CT &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>14&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;14&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;7&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;7&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 &#40;36&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No CT &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>35&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">23 &#40;66&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10 &#40;29&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10 &#40;29&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">28 &#40;80&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15 &#40;43&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">p<a class="elsevierStyleCrossRef" href="#tblfn0020"><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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;085&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;001&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;143&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;143&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;08&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;646&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="7" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">35-35</span><span class="elsevierStyleSup"><span class="elsevierStyleItalic">&#43;6</span></span><span class="elsevierStyleItalic">semanas &#40;n</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">&#61;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">65&#41;</span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">S&#237; CT &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>17&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;6&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;12&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No CT &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>48&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 &#40;13&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13 &#40;27&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;4&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;4&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">32 &#40;67&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;15&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">p<a class="elsevierStyleCrossRef" href="#tblfn0020"><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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;327&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;009&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;000&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;000&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60; 0&#44;0001&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;669&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="7" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">36-36</span><span class="elsevierStyleSup"><span class="elsevierStyleItalic">&#43;6</span></span><span class="elsevierStyleItalic">semanas &#40;n</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">&#61;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">133&#41;</span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">S&#237; CT &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>42&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;2&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;12&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;041&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>CPAP&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">12 &#40;33&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">34 &#40;16&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>No CT &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>145&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>S&#237; CT &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>66&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>No CT &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>145&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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          "es" => "<p id="spar0115" class="elsevierStyleSimplePara elsevierViewall">Estudio comparativo de la morbilidad y necesidades de intervenci&#243;n seg&#250;n peso al nacer y administraci&#243;n de corticoides prenatales</p>"
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        0 => array:2 [
          "identificador" => "bibs0005"
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                      "titulo" => "Infants born late preterm&#58; Epidemiology&#46; Trends and Morbidity Risk"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "C&#46;K&#46; Shapiro-Mendoza"
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                      "Revista" => array:5 [
                        "tituloSerie" => "NeoReviews"
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                      "titulo" => "Epidemiology and causes of preterm birth"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "R&#46;L&#46; Goldenberg"
                            1 => "J&#46;F&#46; Culhane"
                            2 => "J&#46;D&#46; Iams"
                            3 => "R&#46; Romero"
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Información del artículo
ISSN: 16954033
Idioma original: Español
DOI:10.1016/j.anpedi.2014.01.026
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