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existe uma aus&#234;ncia de avalia&#231;&#245;es contempor&#226;neas de resultados perinatais ajustados ao padr&#227;o de partos di&#225;rios&#44; interven&#231;&#245;es obst&#233;tricas e fatores sociodemogr&#225;ficos&#44; que poderiam nos permitir caracterizar esse fen&#244;meno e estabelecer sua magnitude e potencial relev&#226;ncia&#46; Al&#233;m disso&#44; a maior parte das avalia&#231;&#245;es na literatura se refere principalmente a mortalidade&#44; sem analisar a morbidez&#46; Os objetivos deste estudo foram determinar se existem varia&#231;&#245;es significativas no n&#250;mero de partos de acordo com o dia da semana &#40;dia &#250;til ou fim de semana&#41; e se essas varia&#231;&#245;es influenciam a morbidez e mortalidade neonatal de neonatos MBPN&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">M&#233;todo</span><p id="par0010" class="elsevierStylePara elsevierViewall">Analisamos de forma retroativa os dados coletados prospectivamente na rede nacional SEN1500 durante dez anos consecutivos&#58; per&#237;odo de 2002&#8208;2011&#46; As caracter&#237;sticas da base de dados foram descritas em outro lugar<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">13</span></a> e o protocolo de coleta e processamento de dados foi previamente aprovado pelo conselho de revis&#227;o institucional de cada centro&#46; Pacientes nascidos em outro local e rec&#233;m&#8208;nascidos com grandes anomalias cong&#234;nitas foram exclu&#237;dos&#46; Pacientes falecidos na sala de parto &#40;SP&#41; tamb&#233;m foram exclu&#237;dos para evitar um vi&#233;s de sele&#231;&#227;o relacionado &#224; limita&#231;&#227;o eletiva de terapia em pacientes nascidos no limite da viabilidade ou em condi&#231;&#245;es muito prec&#225;rias&#46; Os partos que ocorreram das 8h de segunda&#8208;feira &#224;s 23h59 de sexta&#8208;feira foram considerados partos &#8220;em dia &#250;til&#8221; e aqueles que ocorreram da 0h de s&#225;bado &#224;s 7h59 de segunda&#8208;feira foram considerados partos &#8220;em fim de semana&#8221;&#46; Foram estudados os antecedentes gestacionais&#44; o tipo de parto&#44; as interven&#231;&#245;es perinatais e a morbidez e mortalidade neonatais&#46; Os poss&#237;veis fatores de confus&#227;o com base na revis&#227;o da literatura e aqueles dispon&#237;veis em nossa base de dados foram selecionados para uma an&#225;lise multivariada&#46;</p><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">An&#225;lise estat&#237;stica</span><p id="par0015" class="elsevierStylePara elsevierViewall">Usamos o SPSS &#40;IBM SPSS Statistics for Windows&#44; vers&#227;o 20&#46;0&#46; NY&#44; EUA&#41; para fazer uma an&#225;lise estat&#237;stica&#46; As vari&#225;veis cont&#237;nuas com distribui&#231;&#227;o normal s&#227;o expressas como m&#233;dias e desvio&#8208;padr&#227;o &#40;DP&#41; e as diferen&#231;as entre os grupos foram estudadas com o teste <span class="elsevierStyleItalic">t</span> de Student&#46; As vari&#225;veis qualitativas e as vari&#225;veis com distribui&#231;&#245;es anormais s&#227;o expressas como mediana e intervalo interquartil &#40;IIQ&#41;&#46; Foram feitas compara&#231;&#245;es entre os grupos com o teste qui&#8208;quadrado &#40;&#967;<span class="elsevierStyleSup">2</span>&#41;&#44; o teste exato de Fisher e o teste <span class="elsevierStyleItalic">U</span> de Mann&#8208;Whitney&#44; conforme adequado&#46; Para avaliar o efeito independente do momento do parto&#44; fizemos uma an&#225;lise de regress&#227;o log&#237;stica multivariada e os resultados s&#227;o expressos como raz&#245;es de chance ajustadas &#40;RCa&#41; com intervalos de confian&#231;a de 95&#37; &#40;IC 95&#37;&#41;&#46; Para estudar as probabilidades de sobrevida&#44; usamos o modelo de regress&#227;o de Cox e os resultados s&#227;o expressos como raz&#245;es de risco ajustadas &#40;aHR&#41; com IC 95&#37;&#46; Todas as hip&#243;teses foram submetidas a testes bicaudais e a relev&#226;ncia estat&#237;stica foi estabelecida em p &#60; 0&#44;05 em todas as compara&#231;&#245;es&#46;</p></span></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Resultados</span><p id="par0020" class="elsevierStylePara elsevierViewall">Durante o per&#237;odo do estudo&#44; 27&#46;205 neonatos MBPN foram internados nos centros participantes&#46; Desses&#44; 25&#46;305 &#40;93&#37;&#41; nasceram na pr&#243;pria unidade&#46; Desses&#44; foram exclu&#237;dos 1&#46;533 &#40;6&#44;1&#37;&#41; com grandes anomalias cong&#234;nitas e 253 &#40;1&#37;&#41; falecidos na SP&#46; Os pacientes falecidos na SP estavam significativamente mais imaturos do que neonatos que sobreviveram&#58; idade gestacional &#40;IG&#41; m&#233;dia &#40;DP&#41;&#58; 24&#44;3 &#40;2&#44;3&#41; em compara&#231;&#227;o com 29&#44;2 &#40;2&#44;9&#41; semanas &#40;p &#60; 0&#44;001&#41;&#46; Dados relacionados &#224; limita&#231;&#227;o da terapia foram coletados em 142 &#40;56&#37;&#41; desses 253 pacientes e em 117 &#40;82&#44;4&#37;&#41; casos foi tomada uma decis&#227;o opcional de rejeitar ou suspender a terapia&#46; O hor&#225;rio do parto dos pacientes nascidos na segunda&#8208;feira n&#227;o foi coletado adequadamente em 558 casos&#44; e&#44; consequentemente&#44; eles n&#227;o puderam ser classificados como nascidos no &#8220;fim de semana&#8221; &#40;entre 0h e 7h59&#41; ou &#8220;em dia &#250;til&#8221; &#40;das 8h em diante&#41; e esses casos tamb&#233;m foram exclu&#237;dos do estudo&#46; Por fim&#44; 22&#46;961 &#40;84&#44;4&#37;&#41; rec&#233;m&#8208;nascidos foram inclu&#237;dos na an&#225;lise&#46; A <a class="elsevierStyleCrossRef" href="#fig0005">figura 1</a> apresenta a distribui&#231;&#227;o de partos por dia da semana&#46; Caso a distribui&#231;&#227;o de partos em todos os dias da semana fosse homog&#234;nea&#44; a propor&#231;&#227;o te&#243;rica esperada seria de 14&#44;3&#37; dos partos por dia&#46; Entretanto&#44; a propor&#231;&#227;o m&#233;dia de partos por dia &#250;til foi de 15&#44;3&#37;&#44; ao passo que apenas 11&#44;7&#37; dos partos ocorreram em dias de fim de semana&#44; o que indica uma redu&#231;&#227;o de 24&#37;&#46; Essas propor&#231;&#245;es n&#227;o variaram de forma significativa durante o per&#237;odo do estudo&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">A <a class="elsevierStyleCrossRef" href="#tbl0005">tabela 1</a> apresenta os antecedentes obst&#233;tricos em ambos os grupos de pacientes&#46; As m&#227;es de neonatos nascidos em fins de semana tiveram significativamente menos acompanhamento pr&#233;&#8208;natal &#40;definido como pelo menos uma consulta m&#233;dica durante a gesta&#231;&#227;o&#41;&#44; tecnologia de reprodu&#231;&#227;o assistida &#40;TRA&#41;&#44; corticoterapia antenatal completa&#44; gesta&#231;&#227;o m&#250;ltipla&#44; hipertens&#227;o gestacional&#44; restri&#231;&#227;o do crescimento intrauterino ou parto ces&#225;reo&#46; Por outro lado&#44; as m&#227;es de neonatos nascidos em dias de fim de semana apresentaram uma incid&#234;ncia maior de corioamnionite e de administra&#231;&#227;o de antibi&#243;ticos ap&#243;s o parto&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0030" class="elsevierStylePara elsevierViewall">A <a class="elsevierStyleCrossRef" href="#tbl0010">tabela 2</a> apresenta as caracter&#237;sticas somatom&#233;tricas dos pacientes&#44; sua condi&#231;&#227;o no parto e alguns aspectos relevantes do manejo inicial&#46; Os neonatos nascidos durante fins de semana eram mais imaturos&#44; tinham pesos mais baixos ao nascer e &#237;ndices de Apgar menores no 1&#176; e no 5&#176; minuto ap&#243;s o parto&#46; Embora o uso da press&#227;o positiva cont&#237;nua nas vias a&#233;reas &#40;CPAP&#41; na SP tenha sido semelhante em ambos os grupos&#44; os pacientes nascidos durante fins de semana foram intubados&#44; receberam oxig&#234;nio&#44; epinefrina ou compress&#245;es card&#237;acas com mais frequ&#234;ncia do que os pacientes nascidos em dias &#250;teis&#46; A instabilidade fisiol&#243;gica nas primeiras 12<span class="elsevierStyleHsp" style=""></span>h ap&#243;s a interna&#231;&#227;o&#44; de acordo com o &#205;ndice de Risco Cl&#237;nico para Beb&#234;s&#44;<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">14</span></a> foi maior no grupo do fim de semana&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0035" class="elsevierStylePara elsevierViewall">A <a class="elsevierStyleCrossRef" href="#tbl0015">tabela 3</a> apresenta os achados mais relevantes de morbidez e mortalidade nas an&#225;lises bivariada e de regress&#227;o log&#237;stica&#46; Os pacientes nascidos em fins de semana apresentaram maior incid&#234;ncia de doen&#231;as respirat&#243;rias&#44; instabilidade hemodin&#226;mica&#44; anemia com necessidade de transfus&#227;o&#44; sepse neonatal precoce e de in&#237;cio tardio&#44; enterocolite necrosante &#40;ECN&#41; est&#225;gio 2 ou maior&#44;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">15</span></a> hemorragia intraventricular &#40;IVH&#41; na matriz germinativa de grau 3 ou 4<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">16</span></a> e retinopatia da prematuridade est&#225;gio 2 ou maior&#46;<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">17</span></a> Entretanto&#44; essas diferen&#231;as desapareceram na an&#225;lise multivariada ap&#243;s as corre&#231;&#245;es de IG&#44; peso ao nascer &#40;PN&#41;&#44; sexo&#44; corticoterapia antenatal&#44; gesta&#231;&#227;o m&#250;ltipla&#44; restri&#231;&#227;o do crescimento intrauterino e tipo de parto&#46; Somente a incid&#234;ncia de persist&#234;ncia do canal arterial &#40;PCA&#41; foi significativamente maior entre pacientes nascidos em fins de semana ap&#243;s a corre&#231;&#227;o nos fatores de confus&#227;o&#46; Contudo&#44; esse fato n&#227;o foi associado a maior necessidade de fechamento farmacol&#243;gico ou cir&#250;rgico&#46; Por fim&#44; a mortalidade foi mais alta entre pacientes nascidos em fins de semana &#40;14&#44;2&#37; em compara&#231;&#227;o com 16&#44;5&#37;&#59; p &#60; 0&#44;001&#41;&#44; por&#233;m a probabilidade de sobrevida ap&#243;s o ajuste nas vari&#225;veis de confus&#227;o pela an&#225;lise de regress&#227;o de Cox foi semelhante &#40;aHR&#58; 1&#44;002 &#91;IC 95&#37;&#58; 0&#44;967&#8208;1&#44;038&#93;&#59; p &#61; 0&#44;915&#41;&#46; A disposi&#231;&#227;o de &#243;bitos por dia da semana foi semelhante durante os dias &#250;teis &#40;segunda&#8208;feira&#44; 14&#44;8&#37;&#59; ter&#231;a&#8208;feira&#44; 15&#44;5&#37;&#59; quarta&#8208;feira&#44; 14&#44;6&#37;&#59; quinta&#8208;feira&#44; 14&#44;7&#37;&#59; e sexta&#8208;feira&#44; 15&#44;5&#37;&#41;&#44; ao passo que foi significativamente menor no fim de semana &#40;s&#225;bados&#44; 13&#37; e domingos&#44; 12&#37;&#41; &#40;p &#60; 0&#44;001&#41;&#46; Dentre os 3&#46;280 neonatos que vieram a &#243;bito&#44; foram coletados dados a respeito da limita&#231;&#227;o da terapia em 1&#46;963 casos &#40;59&#44;8&#37;&#41;&#46; A decis&#227;o de rejeitar ou suspender a terapia esteve presente em 644 casos &#40;32&#44;8&#37;&#41; e a decis&#227;o de rejeitar&#47;suspender a terapia foi significativamente maior nos partos em dias &#250;teis &#40;34&#44;4&#37;&#41; do que nos partos em fins de semana &#40;28&#44;1&#37;&#59; p &#61; 0&#44;035&#41;&#46; A faixa et&#225;ria &#233; semelhante nos dois grupos &#40;mediana &#91;IIQ&#93;&#58; 6 &#91;2&#8211;18&#93; em compara&#231;&#227;o com 7 &#91;2&#8211;18&#93; dias&#59; p &#61; 0&#44;288&#41;&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Discuss&#227;o</span><p id="par0040" class="elsevierStylePara elsevierViewall">Nosso estudo apresenta uma redu&#231;&#227;o significativa na ocorr&#234;ncia de partos de neonatos MBPN durante fins de semana em rela&#231;&#227;o aos dias &#250;teis&#44; bem como um aumento na morbidez e na mortalidade&#44; embora as diferen&#231;as tenham desaparecido ap&#243;s o ajuste nas vari&#225;veis de confus&#227;o&#46; Essa redu&#231;&#227;o nos partos em fins de semana j&#225; havia sido indicada h&#225; v&#225;rios anos por outros<a class="elsevierStyleCrossRefs" href="#bib0130"><span class="elsevierStyleSup">1&#8211;6</span></a> e atualmente ainda &#233; observada em diversos pa&#237;ses&#46;<a class="elsevierStyleCrossRefs" href="#bib0160"><span class="elsevierStyleSup">7&#44;12&#44;18&#44;19</span></a> Parece improv&#225;vel que essas diferen&#231;as se devam a um ciclo biol&#243;gico e alguns autores sugerem uma rela&#231;&#227;o com interven&#231;&#245;es obst&#233;tricas&#44; como indu&#231;&#245;es e partos ces&#225;reos opcionais&#46; <a class="elsevierStyleCrossRefs" href="#bib0155"><span class="elsevierStyleSup">6&#44;18&#44;19</span></a> Em nossa configura&#231;&#227;o&#44; a taxa de partos ces&#225;reos nesse grupo de pacientes foi de 71&#44;4&#37; e permaneceu est&#225;vel durante o per&#237;odo de dez anos deste estudo&#44; por&#233;m partos ces&#225;reos foram feitos com mais frequ&#234;ncia em dias &#250;teis&#46; Infelizmente&#44; os dados relativos &#224; indu&#231;&#227;o ou indica&#231;&#227;o de um parto ces&#225;reo n&#227;o foram coletados sistematicamente em nossa base de dados&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">Como mostra a <a class="elsevierStyleCrossRef" href="#tbl0005">tabela 1</a>&#44; nossos dados sugerem que&#44; em certas situa&#231;&#245;es de alto risco &#40;como gesta&#231;&#245;es m&#250;ltiplas&#44; hipertens&#227;o gestacional e restri&#231;&#227;o do crescimento intrauterino&#41;&#44; a decis&#227;o de finalizar a gesta&#231;&#227;o opcionalmente poderia ter sido feita durante os dias &#250;teis&#46; Apesar disso&#44; os beb&#234;s nascidos em fins de semana eram menores&#44; apresentavam &#237;ndices de Apgar menores&#44; precisaram mais de interven&#231;&#227;o durante a reanima&#231;&#227;o e eram mais inst&#225;veis nas primeiras 12 horas de vida&#44; apresentaram mais morbidez na an&#225;lise bivariada&#44; bem como mortalidade 16&#44;2&#37; maior em compara&#231;&#227;o com a mortalidade de neonatos nascidos em dias &#250;teis&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">A compara&#231;&#227;o entre estudos &#233; dif&#237;cil porque a pr&#243;pria defini&#231;&#227;o de fim de semana varia entre eles&#46; Bell et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">20</span></a> por exemplo&#44; consideraram o fim de semana como o per&#237;odo entre a meia&#8208;noite de sexta&#8208;feira e a meia&#8208;noite de domingo&#46; Em outros estudos&#44; esse per&#237;odo se estendia at&#233; a meia&#8208;noite de segunda&#8208;feira&#46; Em nosso estudo&#44; entretanto&#44; decidimos incluir at&#233; as 7h59 de segunda&#8208;feira&#44; devido ao fato de o atendimento durante esse per&#237;odo ser um prolongamento do de domingo em nossos hospitais&#46; Apesar dessas diferen&#231;as&#44; os resultados de alguns estudos foram semelhantes aos nossos&#46; Gould et al&#46;<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">8</span></a> fizeram um estudo nos Estados Unidos entre 1995 e 1997 com pacientes de todas as IGs e PNs&#46; Eles encontraram uma redu&#231;&#227;o de 17&#44;5&#37; no n&#250;mero de partos no fim de semana&#44; juntamente com uma redu&#231;&#227;o na propor&#231;&#227;o de partos ces&#225;reos feitos&#44; de 22&#37; para 16&#37;&#46; A mortalidade neonatal foi de 2&#44;8&#8240; entre beb&#234;s nascidos em dias &#250;teis&#44; em compara&#231;&#227;o com 3&#44;1&#8240; entre beb&#234;s nascidos em fins de semana &#40;RC&#44; 1&#44;12 &#91;IC 95&#37;&#44; 1&#44;05&#8208;1&#44;19&#93;&#59; p &#61; 0&#44;001&#41;&#46; A mortalidade tamb&#233;m foi maior em beb&#234;s nascidos por parto ces&#225;reo do que entre aqueles nascidos por parto normal&#58; 6&#44;85&#8240; em compara&#231;&#227;o com 4&#44;94&#8240;&#44; respectivamente &#40;RC&#44; 1&#44;39 &#91;IC 95&#37;&#44; 1&#44;25&#8208;1&#44;55&#93;&#59; p &#60; 0&#44;001&#41;&#46; Contudo&#44; em ambos os casos&#44; as diferen&#231;as estat&#237;sticas desapareceram ap&#243;s o ajuste ao PN&#46; Da mesma forma&#44; Luo et al&#46;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">19</span></a> fizeram um estudo de base populacional no Canad&#225; entre 1985 e 1998 e relataram uma redu&#231;&#227;o de 24&#37; no n&#250;mero de partos em fins de semana&#44; juntamente com um aumento do risco relativo &#40;RR&#41; de natimortos &#40;RR&#44; 1&#44;06 &#91;IC 95&#37;&#44; 1&#44;02&#8208;1&#44;09&#93;&#41; e mortalidade neonatal precoce &#40;RR&#44; 1&#44;11 &#91;IC 95&#37;&#44; 1&#44;07&#8208;1&#44;16&#93;&#41;&#44; que tamb&#233;m desapareceram ap&#243;s o ajuste &#224; IG&#44; nesse caso&#46; Em outro estudo de base populacional&#44; Salihu et al&#46;<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">21</span></a> estudaram alguns fetos com IGs entre 20 e 44 semanas e relataram maior mortalidade entre neonatos nascidos nos fins de semana &#40;3&#44;25&#8240; em compara&#231;&#227;o com 2&#44;87&#8240;&#41;&#46; O parto ces&#225;reo foi associado ao aumento da mortalidade neonatal &#40;HR&#44; 31&#44;47 &#91;IC 95&#37;&#44; 15&#44;79&#8208;62&#44;74&#93;&#41;&#46; Al&#233;m disso&#44; a mortalidade foi maior em partos ces&#225;reos feitos em fins de semana do que em dias &#250;teis &#40;HR&#44; 4&#44;00 &#91;IC 95&#37;&#44; 1&#44;07&#8208;15&#44;03&#93;&#41;&#46; Entre os fatores sociodemogr&#225;ficos apontados pelos autores como fatores de risco de mortalidade neonatal&#44; estavam idade materna &#60; 18 anos&#44; etnia negra e baixo n&#237;vel de escolaridade dos pais&#46; Neste estudo&#44; as m&#227;es com mais de 35 anos apresentaram melhor progn&#243;stico&#44; supostamente relacionado ao maior controle das gesta&#231;&#245;es e maior ades&#227;o aos planos gestacionais combinados entre pais e profissionais&#46; Em um estudo recente na Inglaterra&#44; ap&#243;s o ajuste &#224; IG&#44; PN e idade materna&#44; a mortalidade perinatal foi maior entre beb&#234;s nascidos em fins de semana &#40;RCa&#44; 1&#44;07 &#91;IC 95&#37;&#44; 1&#44;02&#8208;1&#44;13&#93;&#41; e a incid&#234;ncia de infec&#231;&#245;es puerperais&#44; les&#245;es fetais e reinterna&#231;&#245;es nos primeiros tr&#234;s dias ap&#243;s a alta hospitalar tamb&#233;m foram maiores entre beb&#234;s nascidos nos fins de semana em rela&#231;&#227;o a beb&#234;s nascidos em dias &#250;teis&#46;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">7</span></a> Este estudo sugere que&#44; em fins de semana&#44; ocorreriam&#44; todo ano&#44; aproximadamente 770 &#243;bitos perinatais e 470 infec&#231;&#245;es maternas a mais do que o esperado se o atendimento fosse uniforme ao longo da semana&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Outros estudos apresentam resultados distintos&#46; Em um estudo conduzido por Bell et al&#46;<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">22</span></a> em uma rede de hospitais universit&#225;rios&#44; a restri&#231;&#227;o do hor&#225;rio de trabalho dos residentes n&#227;o influenciou o risco de mortalidade neonatal&#44; o que&#44; em sua opini&#227;o&#44; sugere um padr&#227;o adequado de atendimento dos profissionais&#46; Esse fato &#233; relevante na &#225;rea de neonatologia&#44; j&#225; que o cuidado inicial do paciente nos primeiros poucos minutos de vida contribui de forma significativa para a sobrevida de neonatos extremamente prematuros&#44; bem como para resultados cl&#237;nicos em curto e longo prazos&#46;<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">23</span></a> Em um trabalho recente de Frank&#8208;Wolf et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">24</span></a> apesar de o turno em que o parto ocorre estar relacionado ao tipo de parto&#44; a morbidez neonatal foi semelhante entre os turnos e entre fins de semana e dias &#250;teis&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">Nosso estudo apresenta alguns pontos fortes&#44; mas tamb&#233;m limita&#231;&#245;es&#46; Nossa base de dados coletou informa&#231;&#245;es de aproximadamente dois ter&#231;os de todos os neonatos MBPN na Espanha&#44; inclusive a maior parte das regi&#245;es&#44; com aproximadamente 60 hospitais&#44; principalmente de n&#237;veis 2 e 3&#46; Esse fato reduz a possibilidade de vi&#233;s de sele&#231;&#227;o&#44; uma vez que facilita a generaliza&#231;&#227;o dos resultados&#46; Uma poss&#237;vel limita&#231;&#227;o pode ser o fato de que outros feriados n&#227;o foram levados em considera&#231;&#227;o&#44; durante os quais as poss&#237;veis condi&#231;&#245;es de atendimento podem ser as mesmas que aquelas durante os s&#225;bados e domingos&#46; Isso ocorre porque alguns feriados variam de acordo com comunidades e&#47;ou locais&#44; o que seria imposs&#237;vel de detectar considerando o anonimato dos casos incorporados &#224; base de dados&#46; Por outro lado&#44; pode haver diferen&#231;as organizacionais entre as comunidades e n&#227;o temos dados espec&#237;ficos sobre a disponibilidade de profissionais em cada centro e por dia da semana&#46; Al&#233;m disso&#44; caso uma falta de profissionais ou recursos durante os fins de semana tenha sido uma das causas de varia&#231;&#227;o no n&#250;mero de partos ou resultados perinatais&#44; alguns per&#237;odos do dia&#44; como turnos noturnos&#44; quando pode haver uma escassez semelhante&#44; podem ter mascarado parcialmente nossos resultados dos dias &#250;teis&#46; Nesse sentido&#44; seria interessante saber com certeza as diferen&#231;as no atendimento em turnos noturnos&#44; fins de semana e feriados p&#250;blicos e seu impacto sobre os resultados nos diferentes centros participantes&#46;<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">25</span></a> Outra poss&#237;vel limita&#231;&#227;o &#233; o per&#237;odo do estudo&#44; que &#233; de 10 anos&#44; durante o qual o atendimento perinatal pode ter mudado significativamente&#44; o que poderia ter afetado os resultados de morbidez e mortalidade&#46; Por fim&#44; h&#225; poss&#237;veis vieses inerentes a esse tipo de estudo&#44; derivados de fatores de confus&#227;o desconhecidos&#44; que n&#227;o podem ser inclu&#237;dos e avaliados&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">Para concluir&#44; nossos resultados sugerem que as pr&#225;ticas atuais de atendimento tendem a agrupar partos de alto risco em fins de semana&#44; reduzem significativamente o n&#250;mero de partos em dias &#250;teis&#46; Paradoxalmente&#44; isso gera partos de alto risco urgentes e inesperados em fins de semana&#44; aumenta a morbidez e mortalidade brutas de pacientes nascidos nesses dias&#46; Contudo&#44; ap&#243;s o ajuste aos fatores de risco&#44; essas diferen&#231;as desaparecem&#44; sugerem que a cobertura de atendimento em nossos centros &#233; adequada&#46; Entretanto&#44; &#233; importante destacar que a an&#225;lise feita neste estudo &#233; global&#44; inclui muitos centros de diferentes categorias&#46; O modelo de nosso estudo n&#227;o permite que encontremos diferen&#231;as significativas entre os centros&#46; S&#227;o necess&#225;rios estudos adicionais para entender que fatores organizacionais poderiam influenciar os resultados e&#44; acima de tudo&#44; comparar os sistemas de diferentes institui&#231;&#245;es e generaliz&#225;&#8208;los com resultados melhores&#46; Tamb&#233;m &#233; importante saber as poss&#237;veis inter&#8208;rela&#231;&#245;es entre os fatores maternos&#44; sociodemogr&#225;ficos&#44; institucionais e da comunidade que influenciam os resultados de uma gesta&#231;&#227;o espec&#237;fica&#44; j&#225; que&#44; sem d&#250;vida&#44; esses resultados devem depender do sistema de sa&#250;de como um todo&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Conflitos de interesse</span><p id="par0070" class="elsevierStylePara elsevierViewall">Os autores declaram n&#227;o haver conflitos de interesse&#46;</p></span></span>"
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    "fechaRecibido" => "2017-08-03"
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          "palabras" => array:6 [
            0 => "Very low birth weight infant"
            1 => "Morbidity"
            2 => "Mortality"
            3 => "Weekday birth"
            4 => "Weekend birth"
            5 => "Staffing"
          ]
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          "palabras" => array:6 [
            0 => "Neonato com muito baixo peso ao nascer"
            1 => "Morbidez"
            2 => "Mortalidade"
            3 => "Parto em dia &#250;til"
            4 => "Parto em final de semana"
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        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objective</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">To know the distribution of births of very low birth weight infants by day of the week&#44; and whether this distribution affects the morbidity and mortality in this group of patients&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">This was a retrospective analysis of data collected prospectively in the Spanish SEN1500 network &#40;2002&#8211;2011&#41;&#46; Outborn infants&#44; patients with major congenital anomalies&#44; and those who died in the delivery room were excluded&#46; Births were grouped into &#8220;weekdays&#8221; and &#8220;weekends&#46;&#8221; A multivariate logistic regression analysis was conducted to evaluate the independent effect of the birth moment on outcomes&#44; and Cox regression for survival&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Out of a total of 27&#44;205 very low birth weight infants born at and&#47;or admitted to the participating centers&#44; 22&#44;961 &#40;84&#46;4&#37;&#41; met inclusion criteria&#46; A reduction of 24&#37; in the number of births was observed during the &#8220;weekends&#8221; compared with &#8220;weekdays&#8221;&#46; In the raw analysis&#44; patients born on weekends exhibited higher morbidity and mortality &#40;mortality rate&#58; 14&#46;2&#37; <span class="elsevierStyleItalic">vs</span>&#46; 16&#46;5&#37;&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#44; but differences were no longer significant after adjusting for confounding factors&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">The present results suggest that current care practices reduce the proportion of births during the weekends and tend to cluster some high&#8208;risk births during this period&#44; increasing crude morbidity and mortality&#46; However&#44; after adjusting for confounding factors&#44; the differences disappear&#44; suggesting that overall care coverage in these centers is appropriate&#46;</p></span>"
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        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Objetivo</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Conhecer a distribui&#231;&#227;o dos partos de neonatos com muito baixo peso ao nascer durante a semana e se essa distribui&#231;&#227;o afeta a morbidez e a mortalidade nesse grupo de pacientes&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">M&#233;todo</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Esta &#233; uma an&#225;lise retrospectiva de dados coletados prospectivamente na rede espanhola SEN1500 &#40;2002&#8208;2011&#41;&#46; Foram exclu&#237;dos neonatos nascidos em outro local&#44; pacientes com grandes anomalias cong&#234;nitas e pacientes falecidos na sala de parto&#46; Os partos foram agrupados em &#8220;Dias &#250;teis&#8221; e &#8220;Final de semana&#8221;&#46; Foi realizada uma an&#225;lise de regress&#227;o log&#237;stica multivariada para avaliar o efeito independente do parto sobre os resultados e uma regress&#227;o de Cox para avaliar a sobrevida&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Do total de 27&#46;205 neonatos com muito baixo peso ao nascer nascidos e&#47;ou internados nos centros participantes&#44; 22&#46;961 &#40;84&#44;4&#37;&#41; atenderam aos crit&#233;rios de inclus&#227;o&#46; Houve uma redu&#231;&#227;o de 24&#37; no n&#250;mero de partos no &#8220;Final de semana&#8221; em compara&#231;&#227;o com os &#8220;Dias &#250;teis&#8221;&#46; Na an&#225;lise bruta&#44; os pacientes nascidos em finais de semana apresentaram maior morbidez e mortalidade &#40;Taxa de mortalidade&#58; 14&#44;2&#37; em compara&#231;&#227;o a 16&#44;5&#37;&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#44; por&#233;m as diferen&#231;as n&#227;o eram mais significativas ap&#243;s o ajuste aos fatores de confus&#227;o&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclus&#245;es</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Nossos resultados sugerem que as pr&#225;ticas atuais de atendimento reduzem a propor&#231;&#227;o de partos em finais de semana e tendem a agrupar alguns partos de alto risco nesse per&#237;odo&#44; aumentando a morbidez e mortalidade brutas&#46; Contudo&#44; ap&#243;s o ajuste aos fatores de risco&#44; as diferen&#231;as desaparecem&#44; sugerindo que a cobertura de atendimento geral em nossos centros &#233; adequada&#46;</p></span>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0020">Como citar este artigo&#58; Garc&#237;a&#8208;Mu&#241;oz Rodrigo F&#44; Garc&#237;a Cruz L&#44; Gal&#225;n Henr&#237;quez G&#44; Urqu&#237;a Mart&#237; L&#44; Rivero Rodr&#237;guez S&#44; Garc&#237;a&#8208;&#193;lix A&#44; et al&#46; Variations in the number of births by day of the week&#44; and morbidity and mortality in very&#8208;low&#8208;birth&#8208;weight infants&#46; J Pediatr &#40;Rio J&#41;&#46; 2019&#59;95&#58;41&#8211;7&#46;</p>"
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          "pt" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Distribui&#231;&#227;o de partos por dia da semana e mortalidade&#46;</p> <p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">As colunas mostram a propor&#231;&#227;o de neonatos nascidos em cada dia da semana&#46; A mortalidade indica a propor&#231;&#227;o de neonatos nascidos nesse dia que vieram a &#243;bito&#44; embora o &#243;bito tenha ocorrido em qualquer outro dia da semana&#46; As barras de erro indicam o desvio&#8208;padr&#227;o da m&#233;dia&#46;</p>"
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                  \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">Corioamnionite&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">925&#47;6&#46;134 &#40;15&#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">430&#47;2&#46;459 &#40;17&#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">0&#44;006&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">Antibi&#243;ticos ap&#243;s o parto&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6&#46;967&#47;15&#46;140 &#40;46&#44;0&#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&#46;096&#47;5&#46;960 &#40;51&#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">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Restri&#231;&#227;o do crescimento intrauterino&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#46;676&#47;13&#46;925 &#40;40&#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">1&#46;777&#47;5&#46;607 &#40;31&#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">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Parto ces&#225;reo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">12&#46;056&#47;16&#46;426 &#40;73&#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">4&#46;346&#47;6&#46;535 &#40;66&#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">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
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          "leyenda" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">CPAP&#44; press&#227;o positiva cont&#237;nua nas vias a&#233;reas&#59; CRIB&#44; &#237;ndice de risco cl&#237;nico para beb&#234;s&#59; DP&#44; desvio&#8208;padr&#227;o&#59; IG&#44; idade gestacional&#59;</p><p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">IIQ&#44; intervalo interquartil&#59; PN&#44; peso ao nascer&#59; RCP&#44; reanima&#231;&#227;o cardiopulmonar&#46;</p>"
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                  \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">Vari&#225;vel&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">Dia &#250;til<br>&#40;n &#61; 16&#46;426&#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">Fim de semana<br>&#40;n &#61; 6&#46;535&#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">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">IG &#40;semanas&#41; M&#233;dia &#40;DP&#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">29&#44;3 &#40;2&#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">28&#44;8 &#40;2&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
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                  \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>&#8804; 28 semanas &#40;&#37;&#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="left" valign="top">44&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">PN &#40;g&#41; M&#233;dio &#40;DP&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \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>&#8804; 1000<span class="elsevierStyleHsp" style=""></span>g &#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">34&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">35&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Sexo &#40;masculino&#41; &#40;&#37;&#41;</span>&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">50&#44;3&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">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Apgar &#60; 7 no 5&#176; minuto &#40;&#37;&#41;</span>&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">13&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">RCP</span><a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a><span class="elsevierStyleItalic">na sala de parto</span></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><span class="elsevierStyleItalic">Oxig&#234;nio</span>&nbsp;\t\t\t\t\t\t\n
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                  \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><span class="elsevierStyleItalic">CPAP</span>&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">764&#47;3&#46;142 &#40;24&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
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                  \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><span class="elsevierStyleItalic">Ventila&#231;&#227;o com bal&#227;o e m&#225;scara</span>&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">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Intuba&#231;&#227;o</span>&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">2&#46;423&#47;6&#46;507 &#40;37&#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">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Epinefrina</span>&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">222&#47;6&#46;494 &#40;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">0&#44;013&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><span class="elsevierStyleItalic">Massagem card&#237;aca</span>&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">0&#44;002&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><span class="elsevierStyleItalic">Surfactante na sala de parto</span>&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">532&#47;6&#46;307 &#40;8&#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">0&#44;079&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">&#205;ndice CRIB 1&#58;</span></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>Mediana &#40;IIQ&#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="left" valign="top">2&#44;7 &#40;3&#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">3&#44;0 &#40;3&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
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            1 => array:3 [
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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="" valign="top" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " colspan="3" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">An&#225;lise bivariada</th><th class="td" title="table-head  " colspan="3" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Regress&#227;o log&#237;stica</th></tr><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Vari&#225;vel&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">Dia &#250;til<br>&#40;n &#61; 16&#46;426&#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">Fim de semana<br>&#40;n &#61; 6&#46;535&#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">P&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">RCa&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">IC 95&#37;&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">S&#237;ndrome do desconforto respirat&#243;rio&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8&#46;499&#47;15&#46;934 &#40;53&#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">3&#46;630&#47;6&#46;298 &#40;57&#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">&#60; 0&#44;001&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;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;925&#8208;1&#44;081&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;999&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">Surfactante &#40;a qualquer momento&#41;<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">7&#46;666&#47;16&#46;380 &#40;46&#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">3&#46;357&#47;6&#46;517 &#40;51&#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">&#60; 0&#44;001&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;036&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;959&#8208;1&#44;119&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;375&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">Pneumot&#243;rax&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">688&#47;16&#46;330 &#40;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">322&#47;6&#46;495 &#40;5&#44;0&#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&#44;015&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;003&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;860&#8208;1&#44;170&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;970&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">Corticoterapia para displasia broncopulmonar &#40;DBP&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">827&#47;16&#46;301 &#40;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">379&#47;6&#46;485 &#40;5&#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">0&#44;019&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;054&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;911&#8208;1&#44;220&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;479&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">Oxig&#234;nio por 28 dias&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#46;598&#47;13&#46;412 &#40;26&#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">1&#46;566&#47;5&#46;250 &#40;29&#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">&#60; 0&#44;001&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;022&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;926&#8208;1&#44;128&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;671&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">CPAP por 28 dias&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;304&#47;13&#46;277 &#40;9&#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">577&#47;5&#46;112 &#40;11&#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">0&#44;003&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;009&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;893&#8208;1&#44;140&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;887&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">Ventila&#231;&#227;o mec&#226;nica por 28 dias&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">996&#47;13&#46;287 &#40;7&#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">438&#47;5&#46;121 &#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="left" valign="top">0&#44;016&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;011&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;873&#8208;1&#44;171&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;883&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">Oxig&#234;nio por 36 semanas IPM&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;554&#47;12&#46;248 &#40;12&#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">677&#47;4&#46;659 &#40;14&#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">0&#44;002&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;059&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;941&#8208;1&#44;192&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;343&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="7" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Hipotens&#227;o arterial&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#46;150&#47;15&#46;823 &#40;26&#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&#46;764&#47;6&#46;217 &#40;28&#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">0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;964&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;888&#8208;1&#44;047&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;388&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">Anemia &#40;transfus&#227;o&#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&#46;738&#47;11&#46;300 &#40;41&#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&#46;051&#47;4&#46;484 &#40;45&#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">&#60; 0&#44;001&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;028&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;947&#8208;1&#44;117&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;505&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">Insufici&#234;ncia renal aguda&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">813&#47;11&#46;269 &#40;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">386&#47;4&#46;482 &#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="left" valign="top">0&#44;003&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;074&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;938&#8208;1&#44;229&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;301&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">Persist&#234;ncia do canal arterial &#40;PCA&#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&#46;443&#47;15&#46;927 &#40;27&#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">1&#46;848&#47;6&#46;289 &#40;29&#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">0&#44;028&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;904&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;836&#8208;0&#44;977&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;011&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">Fechamento farmacol&#243;gico de PCA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#46;613&#47;16&#46;134 &#40;22&#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&#46;568&#47;6&#46;411 &#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">0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;970&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;895&#8208;1&#44;052&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;464&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">Liga&#231;&#227;o cir&#250;rgica de PCA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">719&#47;16&#46;329 &#40;4&#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">319&#47;6&#46;494 &#40;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">0&#44;096&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;946&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;814&#8208;1&#44;099&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;468&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="7" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Sepse neonatal de in&#237;cio precoce&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">629&#47;16&#46;271 &#40;3&#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">301&#47;6&#46;477 &#40;4&#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">0&#44;008&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;051&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;891&#8208;1&#44;240&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;554&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">Sepse neonatal de in&#237;cio tardio&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#46;815&#47;16&#46;147 &#40;29&#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">2&#46;008&#47;6&#46;423 &#40;31&#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">0&#44;033&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;990&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;920&#8208;1&#44;064&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;779&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">Candid&#237;ase sist&#234;mica&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">539&#47;13&#46;329 &#40;4&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">255&#47;5&#46;270 &#40;4&#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">0&#44;016&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;083&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;909&#8208;1&#44;289&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;373&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">Enterocolite necrosante &#40;ECN&#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&#46;128&#47;16&#46;317 &#40;6&#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">500&#47;6&#46;493 &#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">0&#44;037&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;051&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;931&#8208;1&#44;187&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;418&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">154&#47;6&#46;480 &#40;2&#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">0&#44;091&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;112&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;898&#8208;1&#44;375&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;330&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">560&#47;16&#46;319 &#40;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">272&#47;6&#46;493 &#40;4&#44;2&#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="left" valign="top">0&#44;996&#8208;1&#44;373&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">655&#47;5&#46;135 &#40;12&#44;8&#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="left" valign="top">1&#44;103&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;980&#8208;1&#44;241&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;105&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">0&#44;975&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;861&#8208;1&#44;104&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;693&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">486&#47;16&#46;309 &#40;3&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
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          "pt" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Morbidez e interven&#231;&#245;es de acordo com o dia do parto&#46; An&#225;lise bivariada &#40;qui&#8208;quadrado&#41; e regress&#227;o log&#237;stica multivariada de morbidez e interven&#231;&#245;es &#40;RCa&#41; em pacientes nascidos em dias do fim de semana em rela&#231;&#227;o aos nascidos em dias &#250;teis</p>"
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        "texto" => "<p id="par0075" class="elsevierStylePara elsevierViewall">Somos extremamente gratos a todos os hospitais e pesquisadores participantes da Rede Neonatal Espanhola SEN1500&#58; Complejo Hospitalario Albacete &#40;Andr&#233;s Mart&#237;nez Guti&#233;rrez&#41;&#59; Hospital U&#46; de Basurto &#40;Alberto P&#233;rez Legorburu&#41;&#59; Hospital Bierzo &#40;Mar&#237;a Teresa Prada&#41;&#59; Hospital Cabue&#241;es &#40;Rafael Garc&#237;a Mozo&#41;&#59; Hospital Carlos Haya &#40;Tom&#225;s S&#225;nchez Tamayo&#41;&#59; Hospital General Castell&#243;n &#40;Ram&#243;n Aguilera Olmos&#41;&#59; Hospital Central Asturias &#40;Bel&#233;n Fern&#225;ndez Colomer&#41;&#59; Hospital Cl&#237;nic Barcelona &#40;Josep Figuera Aloy&#41;&#59; Hospital Cl&#237;nico San Carlos &#40;Araceli Corredera S&#225;nchez&#41;&#59; Hospital Cruces &#40;Amaya Rodr&#237;guez Serna&#41;&#59; Hospital U&#46; Donostia &#40;M&#46; &#193;ngel Cortajarena Altuna&#41;&#59; Hospital Elche &#40;Josep Mut Buigues&#41;&#59; Hospital General de Catalu&#241;a &#40;Laura Castells Vilella&#41;&#59; Hospital G&#46; de Granollers &#40;Israel Anquela Sanz&#41;&#59; Hospital Germans Trias i Pujol &#40;W&#46; Coroleu&#41;&#59; Hospital Getafe &#40;Luc&#237;a Cabanillas Vilaplana&#41;&#59; Hospital Infanta Margarita &#40;Jos&#233; Mar&#237;a Barc&#237;a Ruiz&#41;&#59; Hospital Jerez &#40;Dolores Esquivel Mora&#41;&#59; Hospital Juan Ram&#243;n Jim&#233;nez &#40;Jos&#233; &#193;ngel Morilla S&#225;nchez&#41;&#59; Hospital Juan XXIII &#40;Mar Alb&#250;jar&#41;&#59; Hospital Le&#243;n &#40;Emilio &#193;lvaro Iglesias&#41;&#59; Hospital Miguel Servet &#40;Segundo Rite Gracia&#41;&#59; Corporaci&#243; Parc Taul&#237; &#40;Juan Badia&#41;&#59; Hospital San Juan de Deu &#40;Mart&#237;n Iriondo Sanz&#41;&#59; Hospital San Pedro de Logro&#241;o &#40;In&#233;s Esteban D&#237;ez&#41;&#59; Hospital San Pedro de Alc&#225;ntara &#40;M&#170; Jes&#250;s L&#243;pez Cuesta&#41;&#59; Hospital de la Santa Creu i Sant Pau &#40;Gemma Ginovart Galiana&#41;&#59; Hospital Severo Ochoa &#40;Mar&#237;a Jos&#233; Santos Mu&#241;oz&#41;&#59; Hospital Txagorritxu &#40;Mar&#237;a Mercedes Mart&#237;nez Ayucar&#41;&#59; Hospital Universitario Arnau de Vilanova &#40;Eduard Sol&#233; Mir&#41;&#59; Hospital Valme &#40;Antonio Guti&#233;rrez Benjumea&#41;&#59; Hospital Virgen de la Concha &#40;V&#237;ctor Marug&#225;n Isabel&#41;&#59; Hospital U&#46; Virgen de la Macarena &#40;Mercedes Granero Asencio&#41;&#59; Hospital Virgen de la Salud &#40;Alicia de Ureta Huertas&#41;&#59; Hospital U&#46; Virgen de las Nieves &#40;M&#170; Fernanda Moreno Gald&#243;&#41;&#59; Hospital Xeral Vigo &#40;Mar&#237;a Su&#225;rez Albo&#41;&#59; Hospital Universitario de Valencia &#40;Javier Esta&#241; Capell&#41;&#59; Hospital Universitario de Zaragoza &#40;Purificaci&#243;n Ventura Faci&#41;&#59; Hospital Universitario Santiago &#40;M&#170; Luz Couce Pico&#41;&#59; Hospital General de Burgos &#40;Cristina de Frutos Mart&#237;nez&#41;&#59; Hospital General Universitario Alicante &#40;Miriam Salvador Iglesias&#41;&#59; Hospital Universitario de Fuenlabrada &#40;Laura Domingo Comeche&#41;&#59; Hospital Universitario Gregorio Mara&#241;&#243;n &#40;Amparo Rodr&#237;guez Herreras&#41;&#59; Hospital Universitario La Paz &#40;M&#170; Dolores Elorza&#41;&#59; Hospital Materno Infantil de Canarias &#40;Lourdes Urqu&#237;a Mart&#237;&#41;&#59;Hospital Universitario Canarias &#40;Pedro A&#46; Fuster Jorge&#41;&#59; Hospital Universitario de San Cecilio &#40;Eduardo Narbona&#41;&#59; Hospital Universitari i Politecnic La Fe &#40;Isabel Izquierdo Maci&#225;n&#41;&#59; Hospital Universitario Reina Sof&#237;a &#40;Juana Mar&#237;a Guzm&#225;n Caba&#241;as&#41;&#59; Hospital Universitario R&#237;o Hortera &#40;M&#170; Mar Montejo Vicente&#41;&#59; Hospital Universitario Salamanca &#40;Pilar Garc&#237;a Gonz&#225;lez&#41;&#59; Hospital Universitario Virgen del Roc&#237;o &#40;Carmen Mac&#237;as D&#237;az&#41;&#59; Hospital Universitario Dexeus &#40;Roser Porta&#41;&#59; Scias&#8208;Hospital Barcelona &#40;Silvia Mart&#237;nez&#8208;Nadal&#41;&#59; Hospital Josep Trueta &#40;Alberto Trujillo&#41;&#59; Complejo Hospitalario Universitario de Pontevedra &#40;Javier Vilas Gonz&#225;lez&#41;&#59; Hospital Universitario de Ciudad Real &#40;Miguel &#193;ngel Cabezas&#41;&#59; Hospital Puerta del Mar &#40;Antonio Segado Arenas&#41;&#59; Hospital Doce de Octubre &#40;Carmen R&#46; Pall&#225;s Alonso&#41;&#46;</p>"
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