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mejor monitorizaci&#243;n durante el parto y un aumento de las tasas de ces&#225;rea<a class="elsevierStyleCrossRefs" href="#bib0215"><span class="elsevierStyleSup">4&#44;8</span></a>&#46; Existen numerosos estudios que han analizado las posibles causas de mortalidad fetal en pa&#237;ses desarrollados<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">9</span></a>&#46; Parece que este es un fen&#243;meno multifactorial&#44; en ocasiones dif&#237;cil de explicar&#44; y con m&#250;ltiples clasificaciones etiol&#243;gicas<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">7</span></a>&#46; Diferentes estudios han visto que los factores de riesgo asociados a mortalidad fetal son distintos seg&#250;n la edad gestacional y seg&#250;n el momento en el que se produjo&#44; es decir&#44; si fue anteparto o intraparto<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">7&#44;10&#8211;15</span></a>&#46; Debido a que en pa&#237;ses desarrollados la mortalidad fetal intraparto en el reci&#233;n nacido pret&#233;rmino se suele producir en el medio hospitalario&#44; detectar posibles factores de riesgo asociados a ella adquiere una especial relevancia cl&#237;nica&#46; Sin embargo&#44; no hemos encontrado estudios que de forma espec&#237;fica hayan analizado factores perinatales que puedan aumentar el riesgo de mortalidad fetal intraparto en reci&#233;n nacidos pret&#233;rmino&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">El objetivo de este estudio ha sido analizar la mortalidad fetal en gestaciones entre las semanas 22 y 31<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>6 d&#237;as y detectar posibles factores de riesgo perinatales asociados a mortalidad fetal intraparto&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Poblaci&#243;n y m&#233;todo</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Poblaci&#243;n</span><p id="par0020" class="elsevierStylePara elsevierViewall">El estudio se llev&#243; a cabo en gestantes que presentaron parto pret&#233;rmino entre las semanas 22 y 31<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>6 d&#237;as&#44; en el Hospital General Universitario Gregorio Mara&#241;&#243;n de Madrid &#40;centro de nivel IIIc&#44; referencia de embarazos de alto riesgo y enfermedad neonatal cong&#233;nita&#41;&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">M&#233;todo</span><p id="par0025" class="elsevierStylePara elsevierViewall">Estudio retrospectivo&#44; observacional&#44; que comprende un periodo de 7 a&#241;os &#40;enero de 2008-diciembre de 2014&#41;&#46; Los datos comunes al registro de morbimortalidad SEN 1&#46;500 se recogieron de forma prospectiva&#46; Los factores analizados que no forman parte de este registro se recogieron de forma prospectiva en los a&#241;os 2012-2014 y retrospectiva en los a&#241;os 2008-2011&#46; Este estudio ha sido aprobado por el Comit&#233; de &#201;tica e Investigaci&#243;n Cl&#237;nica &#40;CEIC&#41; del HGU Gregorio Mara&#241;&#243;n&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Se han empleado las definiciones de mortalidad fetal recomendadas por la OMS<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">16</span></a>&#58; mortalidad fetal definida como expulsi&#243;n completa o extracci&#243;n de la madre del producto de la concepci&#243;n&#44; independientemente de la duraci&#243;n de la gestaci&#243;n&#44; que no presenta ning&#250;n signo de vida &#40;no respiraci&#243;n&#44; no latido cardiaco o pulso en cord&#243;n umbilical&#44; o movimiento de m&#250;sculos voluntarios&#41;&#59; mortalidad fetal anteparto cuando el feto fallece antes del momento de iniciarse el parto y mortalidad fetal intraparto cuando el feto est&#225; vivo en el momento de iniciarse el parto&#46; Se complet&#243; la definici&#243;n de mortalidad fetal intraparto como ausencia de signos de vitalidad al minuto 1&#44; 5 y 10 del nacimiento &#40;Apgar 0&#47;0&#47;0&#41;&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Se analiz&#243; la tasa de mortalidad fetal en gestaciones &#8805;<span class="elsevierStyleHsp" style=""></span>22 semanas y entre la semana 22 y 31<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>6 d&#237;as &#40;n&#250;mero de fetos fallecidos por cada 1000 nacimientos&#41;&#46; Nuestro centro es de nivel IIIc donde no se realiza interrupci&#243;n legal del embarazo&#44; por lo que se incluyeron los casos de malformaciones y&#47;o cromosomopat&#237;as severas en el c&#225;lculo de esta tasa&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Para analizar la incidencia acumulada de mortalidad fetal entre las semanas de gestaci&#243;n 22-31<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>6 d&#237;as &#40;n&#250;mero de fetos fallecidos durante este periodo respecto al total de nacimientos en la misma semana de gestaci&#243;n&#41; y los factores de riesgo perinatales asociados a mortalidad fetal intraparto se excluyeron los casos con malformaciones cong&#233;nitas y&#47;o cromosomopat&#237;as con mal pron&#243;stico vital &#40;por el mayor riesgo de fallecimiento intra&#250;tero&#41;&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">Los factores perinatales analizados fueron&#58; edad materna&#59; control del embarazo &#40;desde el comienzo de la gestaci&#243;n&#44; es decir&#44; completo&#41;&#59; enfermedad previa o durante el embarazo&#58; preeclampsia&#44; diabetes gestacional&#44; hemorragia vaginal anteparto&#44; antecedentes obst&#233;tricos desfavorables &#40;&#62;<span class="elsevierStyleHsp" style=""></span>2 abortos espont&#225;neos previos o incompetencia cervical que requiere cerclaje en la gestaci&#243;n actual&#41; y enfermedad cr&#243;nica &#40;hipertensi&#243;n arterial&#44; diabetes mellitus tipo <span class="elsevierStyleSmallCaps">1</span>&#44; obesidad&#44; consumo de t&#243;xicos&#44; enfermedad renal&#44; hep&#225;tica&#44; cardiaca&#44; oncol&#243;gica y autoinmune&#41;&#59; t&#233;cnicas de reproducci&#243;n asistida &#40;TRA&#41;&#59; embarazo m&#250;ltiple&#59; ecograf&#237;a fetal patol&#243;gica &#40;CIR&#44; doppler patol&#243;gico&#44; oligo-anhidramnios y polihidramnios&#41;<a class="elsevierStyleCrossRefs" href="#bib0280"><span class="elsevierStyleSup">17&#44;18</span></a>&#59; rotura prematura de membranas y horas de bolsa rota&#59; administraci&#243;n de antibi&#243;ticos antes del parto&#59; sospecha de corioamnionitis<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">19</span></a>&#59; administraci&#243;n de corticoides prenatales &#40;n&#250;mero de dosis y momento de administraci&#243;n respecto al parto&#41;&#59; v&#237;a de parto &#40;vaginal o ces&#225;rea&#41;&#59; edad gestacional &#40;calculada por ecograf&#237;a fetal precoz en el primer trimestre y por semanas de amenorrea&#46; En embarazos sin controlar&#44; mediante la exploraci&#243;n f&#237;sica del reci&#233;n nacido&#41;&#59; peso al nacimiento&#44; bajo peso para la edad gestacional &#40;percentil &#60;<span class="elsevierStyleHsp" style=""></span>10&#41;<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">20</span></a> y sexo&#46;</p></span></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">An&#225;lisis estad&#237;stico</span><p id="par0050" class="elsevierStylePara elsevierViewall">Los resultados de las variables continuas se presentan mediante su media y desviaci&#243;n t&#237;pica&#46; Para las variables categ&#243;ricas los resultados se presentan por sus frecuencias y porcentajes&#46; Aquellas variables num&#233;ricas con distribuci&#243;n no normal se presentan mediante su mediana y rango intercuart&#237;lico &#40;percentil 25-75&#41;&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Para comparar las medias de 2 grupos se utilizaron pruebas param&#233;tricas &#40;&#171;t&#187; de Student&#41; o pruebas no param&#233;tricas &#40;Mann-Witney&#41; utilizando las m&#225;s adecuadas en cada caso&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">La asociaci&#243;n de mortalidad con variables cualitativas se estudi&#243; mediante la prueba Chi cuadrado de Pearson o exacta de Fisher&#46; La asociaci&#243;n entre variables cuantitativas se estudi&#243; con el coeficiente de correlaci&#243;n de Pearson o Spearman&#46; Se realiz&#243; an&#225;lisis de regresi&#243;n log&#237;stica multivariante para determinar posibles factores asociados a muerte intraparto&#44; con un intervalo de confianza de 95&#37;&#46; El an&#225;lisis estad&#237;stico se realiz&#243; con el programa SPSS<span class="elsevierStyleSup">&#174;</span> versi&#243;n 21&#46;0 y EPIDAT 3&#46;1&#46; Se consideraron como estad&#237;sticamente significativos aquellos resultados con una p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Resultados</span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Mortalidad fetal &#40;<a class="elsevierStyleCrossRefs" href="#tbl0005">tablas 1 y 2</a>&#41;</span><p id="par0065" class="elsevierStylePara elsevierViewall">La media de la tasa de mortalidad fetal en las semanas de gestaci&#243;n 22-31<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>6 d&#237;as fue de 2&#44;3&#8240; &#40;1&#44;1-3&#44;1&#8240;&#41;&#46; En este periodo&#44; el 63&#44;1&#37; &#40;106&#47;168&#41; de la mortalidad fetal se produjo en gestaciones menores de 32 semanas&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0070" class="elsevierStylePara elsevierViewall">En gestaciones entre las semanas 22 y 31<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>6 d&#237;as la incidencia acumulada de mortalidad fetal &#40;excluyendo 6 casos con malformaciones y&#47;o cromosomopat&#237;as&#41; fue del 11&#44;3&#37; &#40;100&#47;882&#44; IC 95&#37;&#58; 9&#44;2-13&#44;8&#41;&#44; con una importante variaci&#243;n seg&#250;n la edad gestacional &#40;62&#44;5&#37; a las 22 semanas de gestaci&#243;n y menos del 10&#37; en gestaciones<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>29 semanas&#41;&#46; La mortalidad fetal intraparto supuso el 2&#44;6&#37; &#40;23&#47;882&#44; IC 95&#37;&#58; 1&#44;5-3&#44;7&#41; del total de nacimientos y el 23&#37; &#40;23&#47;100&#41; de la mortalidad fetal&#46; La mortalidad fetal intraparto fue mayor en gestaciones menores de 25 semanas&#44; y supuso el 37&#44;5&#37; &#40;3&#47;8&#41;&#44; 11&#44;1&#37; &#40;4&#47;36&#41; y 14&#44;7&#37; &#40;9&#47;61&#41; de los nacimientos en las 22&#44; 23 y 24 semanas de gestaci&#243;n &#40;<a class="elsevierStyleCrossRef" href="#fig0005">fig&#46; 1</a>&#41;&#46; El 78&#44;2&#37; &#40;18&#47;23&#41; de los fallecimientos intraparto se produjo en gestantes que ya estaban ingresadas en el nuestro centro &#40;m&#237;nimo 9<span class="elsevierStyleHsp" style=""></span>h y m&#225;ximo 15 d&#237;as&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0075" class="elsevierStylePara elsevierViewall">En 11 de los 23 pacientes fallecidos intraparto se iniciaron medidas de reanimaci&#243;n al nacimiento &#40;en 5 de estos casos se inici&#243; reanimaci&#243;n avanzada con masaje cardiaco<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>administraci&#243;n de adrenalina&#41;&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Factores de riesgo asociados a mortalidad fetal intraparto &#40;<a class="elsevierStyleCrossRefs" href="#tbl0015">tablas 3 y 4</a>&#41;</span><p id="par0080" class="elsevierStylePara elsevierViewall">En la <a class="elsevierStyleCrossRef" href="#tbl0015">tabla 3</a> se muestran los factores perinatales analizados y su comparaci&#243;n entre el grupo de pret&#233;rminos nacidos vivos y fallecidos intraparto&#46; Se encontr&#243; una diferencia estad&#237;sticamente significativa en las t&#233;cnicas de reproducci&#243;n asistida &#40;20&#44;8&#37; vs 41&#44;6&#37;&#44; p<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleMonospace">&#61;</span><span class="elsevierStyleHsp" style=""></span>0&#44;01&#41;&#44; ecograf&#237;a fetal patol&#243;gica &#40;32&#44;7&#37; vs 65&#44;2&#37;&#44; p<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleMonospace">&#61;</span><span class="elsevierStyleHsp" style=""></span>0&#44;001&#44; con un mayor porcentaje de doppler patol&#243;gico y oligoanhidramnios en los pret&#233;rmino fallecidos intraparto&#41;&#44; administraci&#243;n de corticoides antenatales &#40;91&#44;1&#37; vs 34&#44;7&#37;&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#44; indicaci&#243;n de ces&#225;rea &#40;62&#44;7&#37; vs 30&#44;4&#37;&#44; p<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleMonospace">&#61;</span><span class="elsevierStyleHsp" style=""></span>0&#44;002&#41;&#44; edad gestacional &#40;semanas de gestaci&#243;n 28<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>5 d&#237;as vs 24<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>4 d&#237;as&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#44; peso al nacimiento &#40;1&#46;100<span class="elsevierStyleHsp" style=""></span>g vs 650<span class="elsevierStyleHsp" style=""></span>g&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; y bajo peso para la edad gestacional &#40;8&#44;8&#37; vs 26&#37;&#44; p<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleMonospace">&#61;</span><span class="elsevierStyleHsp" style=""></span>0&#44;005&#41;&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><elsevierMultimedia ident="tbl0020"></elsevierMultimedia><p id="par0085" class="elsevierStylePara elsevierViewall">Al realizar el an&#225;lisis multivariante encontramos que las t&#233;cnicas de reproducci&#243;n asistida &#40;OR&#58; 2&#44;6&#59; IC 95&#37;&#58; 1&#44;02-7&#44;55&#41;&#44; la ecograf&#237;a fetal patol&#243;gica &#40;OR&#58; 4&#44;8&#59; IC 95&#37;&#58; 1&#44;6-15&#44;1&#41;&#44; la no administraci&#243;n de corticoides antenatales &#40;OR&#58; 8&#44;27&#59; IC 95&#37;&#58; 2&#44;52-27&#44;15&#41;&#44; la menor edad gestacional &#40;22-25 semanas de gestaci&#243;n&#59; OR&#58; 5&#44;37&#59; IC 95&#37;&#58; 1&#44;21-23&#44;7&#41; y el bajo peso al nacer &#40;OR&#58; 3&#44;67&#59; IC 95&#37;&#58; 1&#44;05-12&#44;9&#41; fueron factores de riesgo independientes asociados a mortalidad fetal intraparto&#46;</p></span></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Discusi&#243;n</span><p id="par0090" class="elsevierStylePara elsevierViewall">Hasta lo que sabemos&#44; este es el primer estudio que analiza de forma espec&#237;fica los factores de riesgo perinatales asociados a mortalidad fetal intraparto en gestaciones de menos de 32 semanas&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">La mortalidad fetal es un indicador fundamental de los cuidados perinatales&#44; y todav&#237;a hoy representa una cifra importante<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">21</span></a>&#46; En nuestro centro la tasa de mortalidad fetal acumulada en gestaciones menores de 32 semanas en este periodo de tiempo fue del 2&#44;3&#8240;&#46; El 63&#44;1&#37; de la mortalidad fetal tuvo lugar entre las 22 y 31<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>6 semanas de gestaci&#243;n&#44; alcanzando en este grupo de pacientes el 11&#44;3&#37; de los nacimientos&#44; con una mortalidad fetal intraparto del 2&#44;6&#37;&#46; Estos porcentajes son similares a otros estudios&#44; aunque existe una gran variabilidad en los resultados publicados&#44; como se muestra en el estudio MOSAIC &#40;mortalidad fetal que oscila entre el 12&#44;8-22&#44;3&#37;&#44; mortalidad intraparto 1&#44;2-4&#44;8&#37;&#41;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">5</span></a>&#46; Pero no siempre los grandes estudios nacionales de supervivencia del reci&#233;n nacido pret&#233;rmino analizan esta mortalidad<a class="elsevierStyleCrossRefs" href="#bib0305"><span class="elsevierStyleSup">22&#44;23</span></a>&#46; En Espa&#241;a una reciente publicaci&#243;n analiz&#243; la mortalidad en reci&#233;n nacidos pret&#233;rmino entre las 23-26 semanas de gestaci&#243;n<a class="elsevierStyleCrossRef" href="#bib0315"><span class="elsevierStyleSup">24</span></a>&#44; pero en esta revisi&#243;n no se incluy&#243; la mortalidad fetal&#46; Sin embargo&#44; es en este grupo de pacientes m&#225;s inmaduros donde la mortalidad fetal alcanza los porcentajes m&#225;s elevados<a class="elsevierStyleCrossRefs" href="#bib0220"><span class="elsevierStyleSup">5&#44;15&#44;25</span></a>&#44; que en nuestra revisi&#243;n fue del 16&#44;2&#37;&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">Existen varios factores que pueden dificultar el an&#225;lisis de la mortalidad fetal&#44; entre ellos la variabilidad de la edad gestacional a partir de la cual se realizan los registros<a class="elsevierStyleCrossRefs" href="#bib0240"><span class="elsevierStyleSup">9&#44;26</span></a>&#44; o la dificultad que en ocasiones hay para diferenciar la mortalidad fetal anteparto e intraparto<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">27</span></a>&#46; Aunque la mortalidad fetal intraparto ha disminuido en los &#250;ltimos a&#241;os&#44; todav&#237;a representa un porcentaje importante<a class="elsevierStyleCrossRefs" href="#bib0220"><span class="elsevierStyleSup">5&#44;25&#44;28</span></a>&#44; en nuestro estudio supuso el 2&#44;6&#37; del total de nacimientos&#44; y este porcentaje de nuevo fue especialmente importante en las gestaciones m&#225;s inmaduras &#60;<span class="elsevierStyleHsp" style=""></span>25 semanas &#40;15&#44;2&#37;&#41;&#46; Otro dato interesante de este an&#225;lisis es que el 78&#44;2&#37; &#40;18&#47;23&#41; de los fallecimientos intraparto se produjeron en gestantes hospitalizadas&#44; y la relevancia de este dato puede ser doble&#46; En primer lugar porque en estos casos es posible un control m&#225;s estrecho antes y durante el parto&#59; y en segundo lugar por la posibilidad que tienen los padres de que se les ofrezca una informaci&#243;n previa al nacimiento&#44; incluyendo habitualmente la estimaci&#243;n de la supervivencia&#44; estimaci&#243;n que debe comenzar cuando existe el riesgo de que se desencadene el parto pret&#233;rmino&#44; no solo cuando el beb&#233; nace vivo&#46; Todo esto hace que la mortalidad fetal intraparto y los factores de riesgo asociados a ella resulten de gran inter&#233;s cl&#237;nico y epidemiol&#243;gico&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">Numerosos autores han analizado los factores de riesgo maternos y obst&#233;tricos asociados a mortalidad fetal<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">7&#44;29&#44;30</span></a>&#46; Algunos estudios han visto que existen diferencias en los factores de riesgo asociados a mortalidad fetal en gestaciones a t&#233;rmino y pret&#233;rmino<a class="elsevierStyleCrossRefs" href="#bib0245"><span class="elsevierStyleSup">10&#44;31</span></a>&#46; Lo mismo sucede con la mortalidad fetal anteparto e intraparto&#44; ya que aunque pueden tener causas comunes&#44; la mortalidad fetal intraparto est&#225; estrechamente asociada a la pr&#225;ctica obst&#233;trica y la hipoxia intrauterina<a class="elsevierStyleCrossRefs" href="#bib0255"><span class="elsevierStyleSup">12&#44;17&#44;28</span></a>&#46; Sin embargo&#44; no hemos encontrado estudios que analicen de forma espec&#237;fica cu&#225;les son los posibles factores de riesgo perinatales asociados a mortalidad fetal intraparto en gestaciones pret&#233;rmino&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">Factores de riesgo asociados a mortalidad fetal intraparto son la edad materna avanzada&#44; los embarazos m&#250;ltiples&#44; la falta de cuidados prenatales&#44; la rotura prematura de membranas o enfermedades cr&#243;nicas como la obesidad<a class="elsevierStyleCrossRefs" href="#bib0255"><span class="elsevierStyleSup">12&#8211;14</span></a>&#46; Otros factores asociados a mortalidad fetal en pret&#233;rminos son el <span class="elsevierStyleItalic">abruptio</span> de placenta&#44; la preeclampsia o la infecci&#243;n intrauterina<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">7&#44;10&#44;11</span></a>&#46; En nuestro estudio no hemos encontrado una diferencia significativa en estos factores de riesgo&#44; y aunque hemos visto que existe un mayor porcentaje de hemorragia obst&#233;trica&#44; enfermedad materna cr&#243;nica y diagn&#243;stico de corioamnionitis&#44; estos datos no fueron estad&#237;sticamente significativos&#46; Si encontramos una asociaci&#243;n significativa con las TRA&#44; ecograf&#237;a fetal patol&#243;gica &#40;doppler patol&#243;gico y oligoanhidramnios&#41;&#44; menor porcentaje de ces&#225;reas&#44; menor administraci&#243;n de corticoides antenatales&#44; menor edad gestacional y bajo peso al nacer&#46; Aunque la realizaci&#243;n de ces&#225;rea se ha visto asociada a una menor mortalidad fetal<a class="elsevierStyleCrossRefs" href="#bib0225"><span class="elsevierStyleSup">6&#44;32</span></a>&#44; al realizar el an&#225;lisis multivariante no hemos encontrado que este sea un factor de riesgo independiente asociado a mortalidad fetal intraparto&#46; La menor edad gestacional<a class="elsevierStyleCrossRefs" href="#bib0270"><span class="elsevierStyleSup">15&#44;21</span></a>&#44; el bajo peso para la edad gestacional<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">12</span></a> y la ecograf&#237;a fetal patol&#243;gica son factores de riesgo de mortalidad fetal conocidos y analizados&#46; El eco-doppler fetal patol&#243;gico es predictivo de compromiso fetal y mortalidad perinatal&#44; especialmente en embarazos de alto riesgo como en casos de insuficiencia placentaria o CIR<a class="elsevierStyleCrossRefs" href="#bib0345"><span class="elsevierStyleSup">30&#44;31&#44;33&#44;34</span></a>&#46; La existencia tanto de oligoamnios como polihidramnios es patol&#243;gica y supone un riego potencial para el feto&#44; pero su impacto sobre la mortalidad fetal es incierto<a class="elsevierStyleCrossRef" href="#bib0360"><span class="elsevierStyleSup">33</span></a>&#46; Sin embargo&#44; un metaan&#225;lisis reciente sugiere que existe una asociaci&#243;n entre oligoanhidramnios y mayor mortalidad perinatal<a class="elsevierStyleCrossRef" href="#bib0370"><span class="elsevierStyleSup">35</span></a>&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">Las TRA suelen estar asociadas a mujeres de edad m&#225;s avanzada&#44; mujeres con enfermedad cr&#243;nica o embarazos m&#250;ltiples&#44; todos ellos factores que pueden aumentar el riesgo de mortalidad fetal&#46; Un reciente estudio encontr&#243; que los embarazos &#250;nicos mediante TRA se asociaron a un mayor riesgo de mortalidad fetal entre las 22-27 semanas de gestaci&#243;n<a class="elsevierStyleCrossRef" href="#bib0375"><span class="elsevierStyleSup">36</span></a>&#46; Sin embargo&#44; no hemos encontrado estudios que hayan analizado de forma espec&#237;fica la asociaci&#243;n entre TRA y mortalidad intraparto&#46; La no administraci&#243;n de corticoides prenatales en reci&#233;n nacidos pret&#233;rmino est&#225; asociada a mayor mortalidad tras el nacimiento y peor evoluci&#243;n a corto y largo plazo<a class="elsevierStyleCrossRefs" href="#bib0380"><span class="elsevierStyleSup">37&#44;38</span></a>&#46; Pero tampoco hemos encontrado estudios que analicen el efecto que estos pueden tener sobre la mortalidad fetal intraparto&#44; aun cuando es muy llamativo como la ausencia de administraci&#243;n de corticoides antenatales claramente se asoci&#243; con un aumento de la mortalidad fetal&#46; Pensamos que este punto es importante&#44; ya que es el &#250;nico factor claramente modificable de todos los encontrados&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">Una de las limitaciones de este estudio es que no analiza los factores de riesgo de mortalidad fetal anteparto&#44; y esto posiblemente requiera de un an&#225;lisis espec&#237;fico en este grupo de pacientes&#46; Otra limitaci&#243;n es que se trata de un estudio retrospectivo no poblacional&#44; sino de un centro &#250;nico donde adem&#225;s se acumula un porcentaje elevado de gestaciones de alto riesgo&#44; con un n&#250;mero limitado de fetos que fallecen intraparto&#46; Por ello ser&#237;a muy interesante realizar estudios m&#225;s amplios que ayudaran a clarificar si estos factores de riesgo tienen un efecto directo sobre la mortalidad intraparto&#44; o son el reflejo de una actitud menos invasiva en aquellos fetos m&#225;s inmaduros con peor pron&#243;stico&#44; ya que las decisiones cl&#237;nicas&#44; influenciadas por el pron&#243;stico fetal&#44; podr&#237;an ser las que tuvieran un mayor efecto en la supervivencia de estos pacientes<a class="elsevierStyleCrossRef" href="#bib0390"><span class="elsevierStyleSup">39</span></a>&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Conclusi&#243;n</span><p id="par0125" class="elsevierStylePara elsevierViewall">La mortalidad fetal intraparto afecta a un porcentaje importante de nacimientos pret&#233;rmino&#46; Su an&#225;lisis resulta de gran inter&#233;s cl&#237;nico&#44; en primer lugar porque la estimaci&#243;n de la supervivencia del reci&#233;n nacido pret&#233;rmino debe comenzar cuando existe el riesgo de que se desencadene el parto pret&#233;rmino&#59; y en segundo lugar&#44; porque analizar los posibles factores asociados a ella puede ayudar a optimizar el cuidado perinatal&#44; y con ello aumentar la supervivencia del reci&#233;n nacido pret&#233;rmino&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Conflicto de intereses</span><p id="par0130" class="elsevierStylePara elsevierViewall">Los autores declaran no tener ning&#250;n conflicto de intereses&#46;</p></span></span>"
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              "titulo" => "Mortalidad fetal &#40;tablas 1 y 2&#41;"
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    "fechaRecibido" => "2015-10-28"
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    "resumen" => array:2 [
      "es" => array:3 [
        "titulo" => "Resumen"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introducci&#243;n</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">El parto prematuro es una de las principales causas de mortalidad perinatal y fetal&#46; Sin embargo&#44; los factores de riesgo perinatales asociados a mortalidad fetal intraparto en partos pret&#233;rmino no han sido bien analizados&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Objetivo</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Analizar la mortalidad fetal y los factores de riesgo perinatales asociados a mortalidad fetal intraparto en gestaciones de menos de 32 semanas&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Material y m&#233;todos</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Se incluyeron en el an&#225;lisis todos los partos pret&#233;rmino entre las semanas 22 y 31<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>6 d&#237;as&#44; nacidos en un hospital terciario durante un periodo de 7 a&#241;os &#40;2008-2014&#41;&#46; Se realiz&#243; an&#225;lisis de regresi&#243;n log&#237;stica para identificar factores de riesgo perinatales asociados a mortalidad fetal intraparto &#40;excluidos malformaciones y cromosomopat&#237;as severas&#41;&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Resultados</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">En este per&#237;odo el 63&#44;1&#37; &#40;106&#47;168&#41; de la mortalidad fetal &#40;&#8805;<span class="elsevierStyleHsp" style=""></span>22 semanas&#41; se produjo en gestaciones menores de 32 semanas&#46; Ochocientos ochenta y dos nacimientos entre las semanas 22 y 31<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>6 d&#237;as fueron incluidos en el an&#225;lisis&#46; La mortalidad fetal fue del 11&#44;3&#37; &#40;100&#47;882&#41;&#46; La mortalidad fetal intraparto fue del 2&#44;6&#37; &#40;23&#47;882&#41;&#44; afectando en el 78&#44;2&#37; de los casos &#40;18&#47;23&#41; a gestantes hospitalizadas&#46; Encontramos que las t&#233;cnicas de reproducci&#243;n asistida&#44; la ecograf&#237;a fetal patol&#243;gica&#44; la no administraci&#243;n de corticoides antenatales&#44; la menor edad gestacional y el bajo peso para la edad gestacional fueron factores de riesgo independientes asociados a mortalidad fetal intraparto&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Conclusi&#243;n</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">La mortalidad fetal intraparto afect&#243; a un porcentaje importante de nacimientos entre las semanas 22 y 31<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>6 d&#237;as&#46; El an&#225;lisis de la mortalidad fetal intraparto y los factores de riesgo asociados a esta resulta de gran inter&#233;s cl&#237;nico y epidemiol&#243;gico para optimizar el cuidado perinatal y aumentar la supervivencia del reci&#233;n nacido pret&#233;rmino&#46;</p></span>"
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        "resumen" => "<span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Introduction</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Pre-term delivery is one of the leading causes of foetal and perinatal mortality&#46; However&#44; perinatal risk factors associated with intra-partum foetal death in preterm deliveries have not been well studied&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Objective</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">To analyse foetal mortality and perinatal risk factors associated with intra-partum foetal mortality in pregnancies of less than 32 weeks gestational age&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Material and methods</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">The study included all preterm deliveries between 22 and 31 &#43;1 weeks gestational age &#40;WGA&#41;&#44; born in a tertiary-referral hospital&#44; over a period of 7 years &#40;2008-2014&#41;&#46; A logistic regression model was used to identify perinatal risk factors associated with intra-partum foetal mortality &#40;foetal malformations and chromosomal abnormalities were excluded&#41;&#46;</p></span> <span id="abst0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Results</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">During the study period&#44; the overall foetal mortality was 63&#46;1&#37; &#40;106&#47;168&#41; &#40;&#8805;<span class="elsevierStyleHsp" style=""></span>22 weeks of gestation&#41; occurred in pregnancies of less than 32 WGA&#46; A total of 882 deliveries between 22 and 31<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>6 weeks of gestation were included for analysis&#46; The rate of foetal mortality was 11&#46;3&#37; &#40;100&#47;882&#41;&#46; The rate of intra-partum foetal death was 2&#46;6&#37; &#40;23&#47;882&#41;&#44; with 78&#46;2&#37; &#40;18&#47;23&#41; of these cases occurring in hospitalised pregnancies&#46; It was found that Assisted Reproductive Techniques&#44; abnormal foetal ultrasound&#44; no administration of antenatal steroids&#44; lower gestational age&#44; and small for gestational age&#44; were independent risk factors associated with intra-partum foetal mortality&#46;</p></span> <span id="abst0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Conclusion</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">This study showed that there is a significant percentage intra-partum foetal mortality in infants between 22 and 31<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>6 WGA&#46; The analysis of intrapartum mortality and risk factors associated with this mortality is of clinical and epidemiological interest to optimise perinatal care and improve survival of preterm infants&#46;</p></span>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0050">Presentaci&#243;n previa en congresos&#58; <span class="elsevierStyleItalic">Risk factors associated with intrapartum stillbirths in preterm babies</span>&#46; 4<span class="elsevierStyleHsp" style=""></span>th International Congress of UENPS&#46; Atenas&#44; 11-14 de diciembre de 2014&#46;</p>"
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          "es" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Fallecimiento anteparto e intraparto seg&#250;n la edad gestacional&#46; Eje Y&#58; porcentaje de nacidos muertos &#40;fallecimiento anteparto e intraparto&#41; con respecto al total de nacimientos&#46; Eje X&#58; edad gestacional en semanas&#46;</p>"
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          "leyenda" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">n&#58; n&#250;mero total de casos por a&#241;o&#59; s&#58; semanas de gestaci&#243;n&#59; &#40;&#37;&#41;&#58; porcentaje con respecto a la mortalidad fetal en gestaciones &#8805;<span class="elsevierStyleHsp" style=""></span>22 semanas&#46;</p>"
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">A&#241;o&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">2008&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">2009&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">2010&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">2011&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">2012&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">2013&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">2014&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Total&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Total de nacimientos&#44; n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8177&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6375&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7707&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6245&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5479&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5416&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5365&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">44764&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Fetos nacidos muertos &#8805;<span class="elsevierStyleHsp" style=""></span>22 s&#44; n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">29&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">30&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">22&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">24&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">22&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">22&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">19&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">168&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Fetos nacidos muertos 22-31<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>6 s&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">24 &#40;82&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">20 &#40;66&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">15 &#40;68&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">17 &#40;70&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">14 &#40;63&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7 &#40;35&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9 &#40;47&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">106 &#40;63&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Tasa de mortalidad fetal<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a><span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>22<span class="elsevierStyleHsp" style=""></span>s&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#44;5&#8240;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#44;7&#8240;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#44;8&#8240;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#44;8&#8240;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#8240;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#44;1&#8240;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#44;5&#8240;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#44;7&#8240;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Tasa mortalidad fetal 22-31<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>6 s&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#44;9&#8240;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#44;1&#8240;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;9&#8240;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#44;7&#8240;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#44;5&#8240;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;1&#8240;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;6&#8240;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#44;3&#8240;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
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                0 => "xTab1351050.png"
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            0 => array:3 [
              "identificador" => "tblfn0005"
              "etiqueta" => "a"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Tasas de mortalidad fetal seg&#250;n recomendaciones de la OMS &#40;por 1&#46;000 nacimientos&#41;&#46;</p>"
            ]
          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Mortalidad fetal en gestaciones<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>22 semanas y entre las semanas 22-31<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>6 d&#237;as &#40;sin tener en cuenta los criterios de exclusi&#243;n&#41;</p>"
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        "etiqueta" => "Tabla 2"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
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        "tabla" => array:3 [
          "leyenda" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">n&#58; n&#250;mero total de casos seg&#250;n la edad gestacional&#59; &#40;&#37;&#41;&#58; porcentaje con respecto al total de nacimientos e intervalo de confianza del 95&#37; seg&#250;n edad gestacional&#46;</p>"
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                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Edad gestacional<br>&#40;semanas&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">22<span class="elsevierStyleHsp" style=""></span>s<br>n<br>&#40;&#37;&#41;<br>&#40;IC 95&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">23<span class="elsevierStyleHsp" style=""></span>s<br>n<br>&#40;&#37;&#41;<br>&#40;IC 95&#37;&#41;<br>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">24<span class="elsevierStyleHsp" style=""></span>s<br>n<br>&#40;&#37;&#41;<br>&#40;IC 95&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">25<span class="elsevierStyleHsp" style=""></span>s<br>n<br>&#40;&#37;&#41;<br>&#40;IC 95&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">26<span class="elsevierStyleHsp" style=""></span>s<br>n<br>&#40;&#37;&#41;<br>&#40;IC 95&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">27<span class="elsevierStyleHsp" style=""></span>s<br>n<br>&#40;&#37;&#41;<br>&#40;IC 95&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">28<span class="elsevierStyleHsp" style=""></span>s<br>n<br>&#40;&#37;&#41;<br>&#40;IC 95&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">29<span class="elsevierStyleHsp" style=""></span>s<br>n<br>&#40;&#37;&#41;<br>&#40;IC 95&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">30<span class="elsevierStyleHsp" style=""></span>s<br>n<br>&#40;&#37;&#41;<br>&#40;IC 95&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">31<span class="elsevierStyleHsp" style=""></span>s<br>n<br>&#40;&#37;&#41;<br>&#40;IC 95&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Total<br>n<br>&#40;&#37;&#41;<br>&#40;IC 95&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Total de nacimientos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">36&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">61&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">88&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">74&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">98&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">117&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">107&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">130&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">163&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">882&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Fetos nacidos muertos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5<br>&#40;62&#44;5&#41;<br>&#40;24&#44;5-91&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10<br>&#40;27&#44;7&#41;<br>&#40;11&#44;8-43&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">12<br>&#40;19&#44;6&#41;<br>&#40;8&#44;9-30&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11<br>&#40;12&#44;5&#41;<br>&#40;5-20&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9<br>&#40;12&#44;1&#41;<br>&#40;4-20&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">12<br>&#40;12&#44;2&#41;<br>&#40;5&#44;2-19&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13<br>&#40;11&#44;1&#41;<br>&#40;5-17&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7<br>&#40;6&#44;5&#41;<br>&#40;1&#44;4-11&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8<br>&#40;6&#44;1&#41;<br>&#40;1&#44;6-10&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13<br>&#40;8&#41;<br>&#40;3&#44;5-12&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">100<br>&#40;11&#44;3&#41;<br>&#40;9&#44;2-13&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Fetos fallecidos anteparto&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2<br>&#40;25&#41;<br>&#40;3&#44;2-65&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6<br>&#40;16&#44;6&#41;<br>&#40;3&#44;1-30&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3<br>&#40;4&#44;9&#41;<br>&#40;1-13&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9<br>&#40;10&#44;2&#41;<br>&#40;3&#44;3-17&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9<br>&#40;12&#44;1&#41;<br>&#40;4-20&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10<br>&#40;10&#44;2&#41;<br>&#40;3&#44;7-16&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13<br>&#40;11&#44;1&#41;<br>&#40;5-17&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6<br>&#40;5&#44;6&#41;<br>&#40;0&#44;8-10&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7<br>&#40;5&#44;4&#41;<br>&#40;1&#44;1-9&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">12<br>&#40;7&#44;4&#41;<br>&#40;3-11&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">77<br>&#40;8&#44;7&#41;<br>&#40;6&#44;8-10&#44;6&#41;<br>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Fetos fallecidos intraparto<br>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3<br>&#40;37&#44;5&#41;<br>&#40;8&#44;5-75&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4<br>&#40;11&#44;1&#41;<br>&#40;3&#44;1-26&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9<br>&#40;14&#44;7&#41;<br>&#40;5-24&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2<br>&#40;2&#44;2&#41;<br>&#40;0&#44;3-8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0<br>&#40;0&#41;<br>&#40;0-4&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2<br>&#40;2&#41;<br>&#40;0&#44;2-7&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0<br>&#40;0&#41;<br>&#40;0-3&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1<br>&#40;0&#44;9&#41;<br>&#40;0&#44;1-5&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1<br>&#40;0&#44;7&#41;<br>&#40;0&#44;02-4&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1<br>&#40;0&#44;6&#41;<br>&#40;0&#44;02-3&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">23<br>&#40;2&#44;6&#41;<br>&#40;1&#44;5-3&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Gestantes hospitalizadas <a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">18&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Nacidos vivos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3<br>&#40;37&#44;5&#41;<br>&#40;8&#44;5-75&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">26<br>&#40;72&#44;2&#41;<br>&#40;56&#44;2-88&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">49<br>&#40;80&#44;3&#41;<br>&#40;69&#44;5-91&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">77<br>&#40;87&#44;5&#41;<br>&#40;80&#44;5-95&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">65<br>&#40;87&#44;8&#41;<br>&#40;79&#44;7-96&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">86<br>&#40;87&#44;7&#41;<br>&#40;80&#44;7-94&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">104<br>&#40;88&#44;8&#41;<br>&#40;82&#44;8-95&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">100<br>&#40;93&#44;4&#41;<br>&#40;88&#44;3-98&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">122<br>&#40;93&#44;9&#41;<br>&#40;89&#44;3-98&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">150<br>&#40;92&#41;<br>&#40;87&#44;6-96&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">782<br>&#40;88&#44;7&#41;<br>&#40;86&#44;5-90&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Datos prenatales analizados&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Nacidos vivo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Fallecidos intraparto&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Total nacimientos&#44; n</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">782&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">23&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Edad materna en a&#241;os&#44; media</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">&#177;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">DE</span><a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">32&#44;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>6&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">33&#44;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>5&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;24&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Control del embarazo&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">749 &#40;95&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">23 &#40;100&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;092&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Enfermedad gestacional materna</span><a class="elsevierStyleCrossRef" href="#tblfn0025"><span class="elsevierStyleSup">c</span></a><span class="elsevierStyleItalic">&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">317 &#40;41&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">12 &#40;52&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;30&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Preeclampsia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">113 &#40;14&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4 &#40;17&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;70&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Diabetes gestacional&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">59 &#40;7&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1 &#40;4&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;55&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Hemorragia obst&#233;trica&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">69 &#40;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4 &#40;17&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;06&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Antecedentes obst&#233;tricos desfavorables&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">97 &#40;12&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3 &#40;13&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;94&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Enfermedad cr&#243;nica&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">78 &#40;10&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5 &#40;21&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;07&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">T&#233;cnicas de reproducci&#243;n asistida &#40;TRA&#41;&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">163 &#40;20&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10 &#40;41&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;01<a class="elsevierStyleCrossRef" href="#tblfn0035"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Embarazo m&#250;ltiple&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">296 &#40;37&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11 &#40;47&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;33&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Ecograf&#237;a fetal patol&#243;gica</span><a class="elsevierStyleCrossRef" href="#tblfn0025"><span class="elsevierStyleSup">c</span></a><span class="elsevierStyleItalic">&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">254 &#40;32&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">15 &#40;65&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;001<a class="elsevierStyleCrossRef" href="#tblfn0035"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>CIR con doppler normal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">39 &#40;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 &#40;8&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;75&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>CIR con doppler patol&#243;gico<a class="elsevierStyleCrossRef" href="#tblfn0030"><span class="elsevierStyleSup">d</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">77 &#40;9&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4 &#40;17&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Doppler patol&#243;gico<a class="elsevierStyleCrossRef" href="#tblfn0030"><span class="elsevierStyleSup">d</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">25 &#40;3&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4 &#40;17&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;04<a class="elsevierStyleCrossRef" href="#tblfn0035"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Oligoanhidramnios&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">140 &#40;18&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10 &#40;43&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;002<a class="elsevierStyleCrossRef" href="#tblfn0035"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Polihidramnios&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10 &#40;1&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1 &#40;4&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;60&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Ces&#225;rea&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">491 &#40;62&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7 &#40;30&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;002<a class="elsevierStyleCrossRef" href="#tblfn0035"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">285 &#40;36&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11 &#40;47&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;26&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Horas de bolsa rota&#44; mediana &#40;p25-75&#41;</span><a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">72 &#40;13-220&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">144 &#40;12-270&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;47&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Antibi&#243;tico materno&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">464 &#40;59&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">15 &#40;65&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;57&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Sospecha corioamnionitis&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">192 &#40;24&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9 &#40;39&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Corticoides prenatales &#40;al menos una dosis&#41;&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">713 &#40;91&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8 &#40;34&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001<a class="elsevierStyleCrossRef" href="#tblfn0035"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Ciclo completo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">393 &#40;50&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5 &#40;21&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;011<a class="elsevierStyleCrossRef" href="#tblfn0035"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Ciclo parcial &#40;una dosis&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">160 &#40;20&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1 &#40;4&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Corticoides<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>7 d&#237;as&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">160 &#40;20&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 &#40;8&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;21&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Ninguna dosis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">69 &#40;8&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">15 &#40;65&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001<a class="elsevierStyleCrossRef" href="#tblfn0035"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Edad gestacional &#40;semanas</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">&#43;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">d&#237;as&#41;&#44; mediana &#40;p25&#59; 75&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">28<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>5 &#40;26<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>3&#59; 30<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">24<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>4 &#40;24&#59; 27&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001<a class="elsevierStyleCrossRef" href="#tblfn0035"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Peso al nacimiento &#40;gramos&#44; g&#41;&#44; media</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">&#177;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">DE</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1100<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>379<span class="elsevierStyleHsp" style=""></span>g&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">650<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>210<span class="elsevierStyleHsp" style=""></span>g&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001<a class="elsevierStyleCrossRef" href="#tblfn0035"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Bajo peso para la edad gestacional&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">69 &#40;8&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6 &#40;26&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;005<a class="elsevierStyleCrossRef" href="#tblfn0035"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Sexo masculino&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">416 &#40;53&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13 &#40;56&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;75&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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          "es" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Comparaci&#243;n de los factores de riesgo perinatales analizados entre reci&#233;n nacidos vivos y fallecidos intraparto &#60;<span class="elsevierStyleHsp" style=""></span>32 semanas de gestaci&#243;n</p>"
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                  <table border="0" frame="\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#44;6&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;005<a class="elsevierStyleCrossRef" href="#tblfn0045"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#40;1&#44;6-15&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001<a class="elsevierStyleCrossRef" href="#tblfn0045"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8&#44;27&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#44;37&nbsp;\t\t\t\t\t\t\n
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        ]
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    "bibliografia" => array:2 [
      "titulo" => "Bibliograf&#237;a"
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          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:39 [
            0 => array:3 [
              "identificador" => "bib0200"
              "etiqueta" => "1"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Fetal death"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "R&#46;M&#46; Silver"
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                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/01.AOG.0000248537.89739.96"
                      "Revista" => array:6 [
                        "tituloSerie" => "Obstet Gynecol"
                        "fecha" => "2007"
                        "volumen" => "109"
                        "paginaInicial" => "153"
                        "paginaFinal" => "167"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17197601"
                            "web" => "Medline"
                          ]
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                      ]
                    ]
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                ]
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            1 => array:3 [
              "identificador" => "bib0205"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "World Health Organization&#46; The World Health Report 2005&#58; Make every mother and child count&#46; Disponible en&#58; <a id="intr0005" class="elsevierStyleInterRef" href="http://www.who.int/whr/2005/whr2005_en.pdf">http&#58;&#47;&#47;www&#46;who&#46;int&#47;whr&#47;2005&#47;whr2005&#95;en&#46;pdf</a>"
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0210"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "PERISTAT Scientific Advisory Committee&#46; PERISTAT&#58; Indicators for monitoring and evaluating perinatal health in Europe"
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