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Grau III &#8211; 3&#44;3&#37; &#40;IC de 95&#37; 2&#44;7&#8208;3&#44;9&#41; e Grau IV &#8211; 3&#44;8&#37; &#40;IC de 95&#37; 3&#44;2&#8208;4&#44;5&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">3</span></a> Em um estudo prospectivo multic&#234;ntrico de neonatos prematuros &#60;<span class="elsevierStyleHsp" style=""></span>32 semanas de idade gestacional nascidos em 10 hospitais americanos&#44; os graus III&#47;IV de IVH estiveram presentes em 5&#37; deles&#46;<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">4</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">A associa&#231;&#227;o de IVH e comprometimento moderado ou grave do desenvolvimento neurol&#243;gico &#40;NDI&#58; paralisia cerebral moderada ou grave&#44; atraso cognitivo moderado ou grave&#44; comprometimento visual grave e&#47;ou comprometimento grave da audi&#231;&#227;o&#41; aos 18&#8208;24 meses corrigida dos neonatos com idade gestacional &#60;<span class="elsevierStyleHsp" style=""></span>34 semanas foi avaliada por metan&#225;lise&#46; 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mas tamb&#233;m os limites dessa organiza&#231;&#227;o&#44; que podem ser testados por meio de situa&#231;&#245;es de estresse&#46; A integridade dos sistemas de modula&#231;&#227;o permite a organiza&#231;&#227;o de respostas comportamentais a situa&#231;&#245;es de estresse&#46;<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">9</span></a> Um dos dom&#237;nios da avalia&#231;&#227;o neurocomportamental &#233; a resposta de habitua&#231;&#227;o&#44; que testa as compet&#234;ncias perceptivas e cognitivas no per&#237;odo neonatal&#46;<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">10</span></a> As pontua&#231;&#245;es de habitua&#231;&#227;o avaliam a capacidade de o neonato diminuir ou abolir a resposta a um est&#237;mulo quando presente por um longo per&#237;odo ou por v&#225;rios curtos per&#237;odos repetidos&#59; contudo&#44; quando um est&#237;mulo novo &#233; mostrado&#44; a aten&#231;&#227;o do neonato ao est&#237;mulo aumentar&#225; posteriormente&#46; Esse padr&#227;o de resposta reflete a capacidade de processamento de informa&#231;&#245;es&#46; O atraso na resposta de habitua&#231;&#227;o a est&#237;mulos externos significa uma menor capacidade de modular a resposta comportamental a um est&#237;mulo de estresse&#46;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">11</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">Poucos estudos examinaram as respostas de habitua&#231;&#227;o em neonatos prematuros a termo e os resultados s&#227;o contradit&#243;rios&#46; Castillo et al&#46; avaliaram neonatos prematuros &#60;<span class="elsevierStyleHsp" style=""></span>32 semanas de gesta&#231;&#227;o prospectivamente e&#44; a termo&#44; eles apresentaram respostas de habitua&#231;&#227;o semelhantes em compara&#231;&#227;o com os nascidos a termo avaliados nos primeiros dias de vida&#46;<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">12</span></a> Pineda et al&#46; constataram que os neonatos prematuros&#44; a termo&#44; apresentaram respostas de habitua&#231;&#227;o piores em compara&#231;&#227;o com os neonatos a termo&#46;<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">13</span></a> A literatura sobre a associa&#231;&#227;o entre o dano cerebral e o neurocomportamento de neonatos prematuros a termo com idade corrigida com o uso da NNNS &#233; escassa&#46; Nos estudos existentes&#44; a IVH grave foi associada a menos aten&#231;&#227;o&#44; mais excitabilidade e maior n&#250;mero de respostas n&#227;o ideais quando os reflexos s&#227;o testados&#46;<a class="elsevierStyleCrossRefs" href="#bib0210"><span class="elsevierStyleSup">13&#44;14</span></a> Somente Pineda et al&#46; avaliaram a associa&#231;&#227;o entre o dano cerebral e as respostas de habitua&#231;&#227;o e n&#227;o encontraram associa&#231;&#227;o&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Nesse contexto&#44; o objetivo deste estudo &#233; avaliar a associa&#231;&#227;o entre a IVH e as respostas de habitua&#231;&#227;o a est&#237;mulos externos em neonatos prematuros &#60;<span class="elsevierStyleHsp" style=""></span>32 semanas de idade gestacional&#44; &#224;s 36&#8208;38 semanas de idade gestacional corrigida&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Material e m&#233;todos</span><p id="par0030" class="elsevierStylePara elsevierViewall">Este &#233; um estudo transversal com neonatos prematuros nascidos em um hospital universit&#225;rio p&#250;blico terci&#225;rio em S&#227;o Paulo&#44; Brasil&#44; entre junho de 2015 e mar&#231;o de 2017&#46; O estudo foi aprovado pelo Comit&#234; de &#201;tica da institui&#231;&#227;o &#40;CAAE 44415915&#46;0&#46;0000&#46;5505&#41;&#46; Os neonatos rec&#233;m&#8208;nascidos foram inscritos para participar ap&#243;s seus pais assinarem o formul&#225;rio de consentimento informado&#46; Inclu&#237;mos consecutivamente neonatos prematuros com idade gestacional abaixo &#60;<span class="elsevierStyleHsp" style=""></span>32 semanas&#44; de acordo com a melhor estimativa obst&#233;trica&#46; Os neonatos com malforma&#231;&#245;es cong&#234;nitas&#44; s&#237;ndromes gen&#233;ticas&#44; infec&#231;&#245;es cong&#234;nitas&#44; dist&#250;rbios musculares ou outros dist&#250;rbios neurol&#243;gicos ou aqueles que morreram durante a interna&#231;&#227;o foram exclu&#237;dos&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Foram feitas ultrassonografias da cabe&#231;a na unidade pelo menos tr&#234;s vezes no primeiro m&#234;s ap&#243;s o nascimento&#58; nos dias de vida 3&#8208;4&#44; 7&#8208;10 e 28&#8208;30 com o Sistema de Ultrassom Acuson X300 &#40;Siemens Healthineers&#44; Erlangen&#44; Alemanha&#41; e um transdutor 3&#44;5<span class="elsevierStyleHsp" style=""></span>MHz&#46; Foi usada a fontanela anterior &#40;janela&#41; com incid&#234;ncias axiais&#44; coronais e sagitais&#46; Os exames foram feitos por radiologistas do Departamento de Diagn&#243;stico por Imagem da Escola Paulista de Medicina&#44; Universidade Federal de S&#227;o Paulo&#44; cegos para a avalia&#231;&#227;o comportamental dos neonatos&#46; Os exames sempre foram revisados pelo radiologista pedi&#225;trico s&#234;nior&#46; A hemorragia&#44; se presente em um ou mais exames&#44; foi classificada de acordo com Papile et al&#46;<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">2</span></a> O grau mais elevado de hemorragia observado nos exames foi considerado para cada rec&#233;m&#8208;nascido&#44; quando presente&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">As respostas de habitua&#231;&#227;o foram avaliadas com o neonato vestido em uma sala aquecida e calma&#44; com baixa luminosidade&#44; em um ber&#231;o normal&#44; antes da alta hospitalar&#44; &#224;s 36&#8208;38 semanas de idade gestacional corrigida&#46; No momento do exame&#44; os neonatos estavam no ar ambiente&#44; sem acesso venoso e recebiam alimenta&#231;&#227;o oral&#46; Todos os exames foram feitos pelo primeiro autor&#44; treinado por um pesquisador certificado para fazer a NNNS no Hospital da Ilha de Rodes&#44; Brown University&#44; RI&#44; de acordo com o Estudo de Estilo de Vida Materno&#46;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">15</span></a> O exame neurocomportamental teve in&#237;cio com a observa&#231;&#227;o do estado de sono&#8208;vig&#237;lia e a avalia&#231;&#227;o das respostas de habitua&#231;&#227;o a est&#237;mulos externos teve in&#237;cio somente quando o paciente estava no estado de sono&#8208;vig&#237;lia exigido para cada teste&#46;<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">6</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">Os est&#237;mulos externos foram apresentados sempre na mesma ordem&#58; est&#237;mulo luminoso &#40;uma lanterna padr&#227;o de oito polegadas foi aluminada 30<span class="elsevierStyleHsp" style=""></span>cm do neonato&#44; diretamente nos olhos por dois segundos&#41;&#59; est&#237;mulo auditivo &#8211; chocalho e campainha &#40;o chocalho foi agitado duas vezes a 30<span class="elsevierStyleHsp" style=""></span>cm do neonato e&#44; ap&#243;s isso&#44; a mesma a&#231;&#227;o foi feita com a campainha&#41;&#59; est&#237;mulos t&#225;teis &#40;o calcanhar foi pressionado de forma suave&#44; por&#233;m firme&#44; com um bast&#227;o pl&#225;stico&#41;&#46; Os est&#237;mulos luminosos e auditivos foram apresentados at&#233; dez vezes e os est&#237;mulos t&#225;teis foram apresentados at&#233; cinco vezes&#46; O pr&#243;ximo est&#237;mulo foi apresentado cinco segundos ap&#243;s o neonato cessar a resposta&#46; Para pontuar a resposta&#44; o est&#237;mulo ao qual o neonato respondeu primeiro foi considerado a apresenta&#231;&#227;o inicial&#46; Caso&#44; ap&#243;s duas tentativas&#44; ainda n&#227;o tivesse havido resposta ou caso a resposta do neonato ao est&#237;mulo tivesse durado mais de 45 segundos&#44; foi aplicado o pr&#243;ximo item de habitua&#231;&#227;o&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">A resposta de habitua&#231;&#227;o foi avaliada com base na capacidade de o neonato cessar&#44; diminuir ou atrasar suas respostas &#224; apresenta&#231;&#227;o repetida de um est&#237;mulo&#46; A resposta foi considerada presente se o neonato mostrou movimenta&#231;&#227;o de todo o corpo ou do membro&#44; movimentos de contor&#231;&#227;o ou piscar de olhos com caretas faciais&#46; As respostas foram pontuadas como segue&#58; 1 &#8211; nenhum decr&#233;scimo nas respostas nos 10 est&#237;mulos&#59; 2 &#8211; nenhum decr&#233;scimo nas respostas&#44; por&#233;m algum atraso nas repostas nas 10 tentativas&#59; 3 &#8211; algum decr&#233;scimo nas respostas nas 10 tentativas&#44; por&#233;m n&#227;o cessou completamente&#59; 4 &#8211; algum decr&#233;scimo nas respostas e atraso nas respostas nas 10 tentativas&#44; por&#233;m n&#227;o cessou completamente&#59; 5 &#8211; cessou as respostas ap&#243;s nove est&#237;mulos&#59; 6 &#8211; cessou as respostas ap&#243;s 7&#8208;8 est&#237;mulos&#59; 7 &#8211; cessou as respostas ap&#243;s 5&#8208;6 est&#237;mulos&#59; 8 &#8211; cessou as respostas ap&#243;s 3&#8208;4 est&#237;mulos&#59; 9 &#8211; cessou as respostas ap&#243;s 1&#8208;2 est&#237;mulos&#46; As pontua&#231;&#245;es 5&#8208;9 indicam habitua&#231;&#227;o bem&#8208;sucedida e as pontua&#231;&#245;es 4 ou menores foram consideradas decr&#233;scimo nas respostas incompletas&#46;<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">6</span></a></p><p id="par0055" class="elsevierStylePara elsevierViewall">Para est&#237;mulos t&#225;teis&#44; as respostas de habitua&#231;&#227;o foram pontuadas como segue&#58; 1 &#8211; resposta generalizada em todo o corpo e aumentou com as tentativas&#59; 2 &#8211; os dois p&#233;s foram retirados sem decr&#233;scimo na resposta&#59; 3 &#8211; resposta vari&#225;vel aos est&#237;mulos com decr&#233;scimo nas respostas&#59; 4 &#8211; decr&#233;scimo nas respostas ap&#243;s 5 tentativas localizadas a est&#237;mulos nas pernas e nenhuma mudan&#231;a no estado de alerta&#59; 5 &#8211; decr&#233;scimo nas respostas ap&#243;s 5 tentativas localizadas a est&#237;mulos nos p&#233;s e nenhuma mudan&#231;a no estado de alerta&#59; 6 &#8211; resposta limitada a est&#237;mulos nos p&#233;s ap&#243;s 3&#8208;4 tentativas e nenhuma mudan&#231;a no estado de alerta&#59; 7 &#8211; resposta limitada a est&#237;mulos nos p&#233;s ou decr&#233;scimo total na resposta ap&#243;s 1&#8208;2 tentativas e nenhuma mudan&#231;a no estado de alerta&#59; 8 &#8211; resposta localizada e m&#237;nima ap&#243;s duas tentativas e mudan&#231;a no estado de alerta&#59; 9 &#8211; decr&#233;scimo total nas respostas e mudan&#231;a no estado de alerta&#46; Para habitua&#231;&#227;o a est&#237;mulos t&#225;teis&#44; n&#227;o h&#225; defini&#231;&#227;o da pontua&#231;&#227;o acima na qual a habitua&#231;&#227;o &#233; considerada presente&#46;<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">6</span></a></p><p id="par0060" class="elsevierStylePara elsevierViewall">Os seguintes dados foram coletados&#58; caracter&#237;sticas maternas&#44; caracter&#237;sticas demogr&#225;ficas neonatais&#44; ao Escore para Fisiologia Neonatal Aguda &#8211; Extens&#227;o Perinatal &#40;Snappe&#8208;II&#41;<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">16</span></a> e morbidez durante o tempo de interna&#231;&#227;o&#46; As interven&#231;&#245;es terap&#234;uticas&#44; como ventila&#231;&#227;o mec&#226;nica &#40;presen&#231;a e n&#250;mero de dias&#41;&#44; surfactante ex&#243;geno&#44; ibuprofeno&#44; analg&#233;sicos&#44; sedativos e uso p&#243;s&#8208;natal de esteroides&#44; tamb&#233;m foram coletadas&#46; Na alta&#44; os dados estudados inclu&#237;ram&#58; idade cronol&#243;gica&#44; idade p&#243;s&#8208;conceptual&#44; peso e per&#237;metro cef&#225;lico&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">O tamanho da amostra necess&#225;rio para detectar uma diferen&#231;a m&#233;dia de 1 ponto nas pontua&#231;&#245;es de habitua&#231;&#227;o entre os neonatos prematuros com e sem IVH&#44; com desvio padr&#227;o de 1&#44; erro alfa de 5&#37; e poder de 80&#37;&#44; foi de 16 rec&#233;m&#8208;nascidos em cada grupo&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">As pontua&#231;&#245;es das respostas de habitua&#231;&#227;o foram comparadas entre os grupos pelo teste <span class="elsevierStyleItalic">t</span> de Student&#46; Quatro modelos de regress&#227;o linear m&#250;ltipla foram criados com pontua&#231;&#245;es de habitua&#231;&#227;o para os est&#237;mulos de luz&#44; chocalho&#44; campainha e t&#225;teis como as vari&#225;veis dependentes e IVH como uma vari&#225;vel independente e ajustados para os seguintes vari&#225;veis de confus&#227;o&#58; idade gestacional&#44; idade na avalia&#231;&#227;o da habitua&#231;&#227;o&#44; sepse cl&#237;nica&#44; displasia broncopulmonar &#40;depend&#234;ncia de oxig&#234;nio com 28 dias&#41; e escore Snappe&#8208;II &#62; 15 &#40;pontua&#231;&#227;o m&#233;dia da popula&#231;&#227;o estudada&#41;&#44; presumiu&#8208;se o n&#250;mero m&#237;nimo de 10 pacientes para cada fator inclu&#237;do na an&#225;lise&#46; A an&#225;lise foi feita com o SPSS &#40;Pacote SPSS Statistics para Windows&#44; vers&#227;o 20&#46;0&#44; IBM&#44; Somers&#44; NY&#44; EUA&#41;&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Resultados</span><p id="par0075" class="elsevierStylePara elsevierViewall">De junho de 2015 a mar&#231;o de 2017&#44; 130 neonatos prematuros com idade gestacional &#60;<span class="elsevierStyleHsp" style=""></span>32 semanas nasceram no hospital do estudo&#46; Entre esses&#44; 65 atenderam a um ou mais crit&#233;rios de exclus&#227;o&#58; malforma&#231;&#245;es cong&#234;nitas &#40;27&#41;&#44; infec&#231;&#245;es cong&#234;nitas &#40;5&#41;&#44; &#243;bito durante a interna&#231;&#227;o &#40;23&#41;&#44; recusa a participar do estudo &#40;6&#41; e n&#227;o avaliado &#40;4&#41;&#46; Portanto&#44; 65 beb&#234;s foram estudados&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">Os neonatos prematuros fizeram uma m&#233;dia de 3&#44;1 &#177; 1&#44;5 &#40;varia&#231;&#227;o&#58; 1&#8208;9&#41; ultrassonografias de cabe&#231;a durante o tempo de interna&#231;&#227;o&#46; O primeiro exame foi feito em todos os 65 neonatos&#44; com mediana de 5 &#40;1&#8208;17&#41; dias ap&#243;s o nascimento&#59; 59 &#40;91&#37;&#41; fizeram dois exames com 13 &#40;6&#8208;39&#41; dias de vida&#59; 38 &#40;58&#37;&#41; fizeram tr&#234;s exames com 26 &#40;12&#8208;52&#41; dias&#59; 21 &#40;32&#37;&#41; fizeram quatro exames com 32 &#40;17&#8208;69&#41; dias de vida&#59; 9 &#40;14&#37;&#41; fizeram cinco exames com 41 &#40;30&#8208;58&#41; dias de vida&#59; e 8 &#40;12&#37;&#41; neonatos fizeram mais de cinco exames durante o tempo de interna&#231;&#227;o&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">IVH foi identificada em 20 &#40;30&#44;8&#37;&#41; neonatos&#44; grau I em 12 &#40;60&#44;0&#37;&#41;&#44; grau II em 4 &#40;20&#44;0&#37;&#41;&#44; grau III em 2 &#40;10&#44;0&#37;&#41; e grau IV em 2 &#40;10&#44;0&#37;&#41;&#46; Em 11 neonatos &#40;55&#37;&#41;&#44; o diagn&#243;stico de IVH foi feito nos primeiros 10 dias de vida&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">As caracter&#237;sticas demogr&#225;ficas e cl&#237;nicas das m&#227;es e dos neonatos com e sem IVH foram semelhantes&#44; exceto que os neonatos prematuros com IVH&#44; em compara&#231;&#227;o com os sem IVH&#44; apresentaram menor idade gestacional&#44; peso ao nascer e per&#237;metro cef&#225;lico no nascimento e um escore Snappe&#8208;II maior &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">tabela 1</a>&#41;&#46; Somente uma m&#227;e em cada grupo fez uso de maconha durante a gesta&#231;&#227;o&#46; A <a class="elsevierStyleCrossRef" href="#tbl0010">tabela 2</a> mostra a morbidez e as interven&#231;&#245;es terap&#234;uticas recebidas durante o tempo de interna&#231;&#227;o&#46; Os neonatos com IVH usaram ibuprofeno e sedativos e&#47;ou analg&#233;sicos com mais frequ&#234;ncia do que os sem IVH&#59; contudo&#44; eles n&#227;o usaram qualquer desses medicamentos no momento do exame neurocomportamental&#46; Apesar de tr&#234;s neonatos n&#227;o terem apresentado emiss&#245;es otoac&#250;sticas bilaterais e de oito terem apresentado fun&#231;&#227;o auditiva anormal do tronco encef&#225;lico auditivo&#44; seu limiar tonal foi entre 40&#8208;50<span class="elsevierStyleHsp" style=""></span>dB&#46; Como a intensidade do som do chocalho e da campainha &#233; de 90&#8208;100<span class="elsevierStyleHsp" style=""></span>dB&#44; os neonatos conseguiram escutar o chocalho e a campainha&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0095" class="elsevierStylePara elsevierViewall">A <a class="elsevierStyleCrossRef" href="#tbl0015">tabela 3</a> mostra as respostas de habitua&#231;&#227;o dos neonatos a est&#237;mulos externos&#46; A avalia&#231;&#227;o foi feita em uma idade p&#243;s&#8208;natal e p&#243;s&#8208;conceptual mais avan&#231;ada em neonatos prematuros com IVH&#46; N&#227;o foi encontrada diferen&#231;a entre os neonatos com e sem IVH com rela&#231;&#227;o ao tempo ap&#243;s a &#250;ltima alimenta&#231;&#227;o na avalia&#231;&#227;o &#40;66 &#177; 21 em compara&#231;&#227;o com 69 &#177; 46 minutos&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;701&#41; ou a dura&#231;&#227;o do exame &#40;13 &#177; 4 em compara&#231;&#227;o com 13 &#177; 5 minutos&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;812&#41;&#46; Os neonatos prematuros com IVH apresentaram menores pontua&#231;&#245;es de habitua&#231;&#227;o a luz e som&#44; por&#233;m nenhuma diferen&#231;a nos est&#237;mulos t&#225;teis&#46; Os neonatos prematuros sem IVH apresentaram uma resposta de habitua&#231;&#227;o completa a luz e som ap&#243;s 7&#8208;8 est&#237;mulos&#44; ao passo que os com IVH mostraram uma redu&#231;&#227;o e atraso na reposta ao est&#237;mulo&#44; por&#233;m habitua&#231;&#227;o incompleta&#46; Ao comparar a frequ&#234;ncia de sucesso na resposta de habitua&#231;&#227;o a luz e som&#44; isso foi menos frequente em neonatos com IVH&#44; em compara&#231;&#227;o com os sem IVH&#46; A associa&#231;&#227;o entre a presen&#231;a de IVH e a varia&#231;&#227;o das respostas de habitua&#231;&#227;o aos diferentes est&#237;mulos mostrou que a IVH foi associada &#224; redu&#231;&#227;o nas pontua&#231;&#245;es de habitua&#231;&#227;o a luz e som&#44; mesmo ap&#243;s controlar a idade gestacional no nascimento&#44; idade na avalia&#231;&#227;o comportamental&#44; sepse cl&#237;nica&#44; displasia broncopulmonar e o escore de gravidade Snappe&#8208;II &#40;<a class="elsevierStyleCrossRef" href="#tbl0020">tabela 4</a>&#41;&#46; A IVH n&#227;o foi associada &#224; pontua&#231;&#227;o de habitua&#231;&#227;o aos est&#237;mulos t&#225;teis&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><elsevierMultimedia ident="tbl0020"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Discuss&#227;o</span><p id="par0100" class="elsevierStylePara elsevierViewall">Os neonatos prematuros &#60;<span class="elsevierStyleHsp" style=""></span>32 semanas de gesta&#231;&#227;o com IVH&#44; quando examinados antes da alta hospitalar&#44; apresentaram menos respostas de habitua&#231;&#227;o a est&#237;mulos luminosos e sonoros externos&#44; em compara&#231;&#227;o com os sem IVH&#46; Deve&#8208;se notar que os neonatos com IVH foram avaliados em uma idade corrigida de 37&#44;9 semanas e aqueles sem IVH &#224;s 36&#44;5 semanas&#46; Isso aconteceu porque os neonatos com IVH foram internados por per&#237;odos mais longos&#44; pois eles eram mais imaturos e mais doentes&#44; e os dois grupos foram avaliados pr&#243;ximo &#224; alta hospitalar&#46; Portanto&#44; a an&#225;lise m&#250;ltipla foi ajustada para essas poss&#237;veis vari&#225;veis de confus&#227;o&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">IVH foi identificada em 30&#44;8&#37; dos neonatos prematuros&#44; 80&#37; leve e 20&#37; grave&#46; O Projeto de Base de Dados da Vermont Oxford Trial Network relatou uma frequ&#234;ncia de IVH de 26&#37; entre neonatos prematuros com muito baixo peso ao nascer internados em 38 unidades neonatais da Am&#233;rica do Norte&#46;<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">17</span></a> Mais recentemente&#44; o Instituto Nacional de Sa&#250;de Infantil e Desenvolvimento Humano Rede de Pesquisa Neonatal Eunice Kennedy Shriver mostrou uma incid&#234;ncia de IVH grave de 5&#37; em neonatos com &#60;<span class="elsevierStyleHsp" style=""></span>28 semanas de idade gestacional&#46;<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">1</span></a> Em 20 hospitais universit&#225;rios p&#250;blicos brasileiros&#44; identificamos IVH grave em 10&#37; dos neonatos prematuros com idade gestacional de 23 a 33 semanas&#46;<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">18</span></a> Uso mais frequente de corticoterapia antenatal e melhores pr&#225;ticas no cuidado neonatal no Brasil ainda s&#227;o necess&#225;rios para reduzir a frequ&#234;ncia da IVH em neonatos prematuros&#46;<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">18</span></a></p><p id="par0110" class="elsevierStylePara elsevierViewall">Estudos mostraram que a IVH est&#225; associada a um pior desenvolvimento global na inf&#226;ncia&#46;<a class="elsevierStyleCrossRefs" href="#bib0180"><span class="elsevierStyleSup">7&#44;8</span></a> Em neonatos extremamente prematuros&#44; aqueles com hemorragia intraventricular grau III&#8208;IV&#44; em compara&#231;&#227;o com aqueles sem IVH&#44; apresentam maiores taxas de atraso no desenvolvimento &#40;43&#44;0&#37; em compara&#231;&#227;o com 12&#44;1&#37;&#41;&#44; paralisia cerebral &#40;30&#44;1&#37; em compara&#231;&#227;o com 6&#44;5&#37;&#41;&#44; surdez &#40;8&#44;6&#37; em compara&#231;&#227;o com 2&#44;3&#37;&#41; e cegueira &#40;2&#44;2&#37; em compara&#231;&#227;o com 0&#44;2&#37;&#41;&#46; A alta frequ&#234;ncia de comprometimento do desenvolvimento tamb&#233;m foi encontrada em neonatos com IVH graus I&#8208;II&#44; em compara&#231;&#227;o com aqueles sem IVH&#58; &#40;22&#44;0&#37; em compara&#231;&#227;o com 12&#44;1&#37;&#41;&#44; paralisia cerebral &#40;10&#44;4&#37; em compara&#231;&#227;o com 6&#44;5&#37;&#41; e surdez &#40;6&#44;0&#37; em compara&#231;&#227;o com 2&#44;3&#37;&#41;&#46; Mesmos ap&#243;s a exclus&#227;o de outras anomalias no ultrassom&#44; inclusive leucomal&#225;cia&#44; porencefalia e aumento ventricular&#44; a IVH graus I&#8208;II isolada foi associada ao aumento nas taxas de comprometimento neurossensorial moderado&#8208;grave &#40;18&#44;6&#37; em compara&#231;&#227;o com 12&#44;1&#37;&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">19</span></a> Em outro estudo&#44; os neonatos com peso ao nascer &#60;<span class="elsevierStyleHsp" style=""></span>1&#46;000<span class="elsevierStyleHsp" style=""></span>g e IVH graus I&#47;II apresentaram uma maior frequ&#234;ncia de MDI &#60;<span class="elsevierStyleHsp" style=""></span>70 e anormalidades motoras e neurossensoriais em compara&#231;&#227;o com aqueles sem IVH&#46;<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">20</span></a> Outro estudo tamb&#233;m mostrou que&#44; mesmo quando a resson&#226;ncia magn&#233;tica cerebral foi normal&#44; neonatos extremamente prematuros apresentam desempenho cognitivo e motor mais baixo aos 30 meses de idade corrigida em compara&#231;&#227;o com os neonatos nascidos a termo&#46;<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">21</span></a> Como as mudan&#231;as comportamentais nos neonatos prematuros avaliados em idade p&#243;s&#8208;conceptual a termo tamb&#233;m s&#227;o associadas a um desenvolvimento mais baixo na inf&#226;ncia&#44;<a class="elsevierStyleCrossRefs" href="#bib0180"><span class="elsevierStyleSup">7&#44;8&#44;22&#44;23</span></a> &#233; interessante identificar as caracter&#237;sticas neurocomportamentais dos neonatos prematuros com les&#245;es cerebrais&#46; As respostas de habitua&#231;&#227;o s&#227;o um dom&#237;nio importante do neurocomportamento neonatal&#44; pois elas avaliam as compet&#234;ncias de percep&#231;&#227;o e cognitivas<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">10</span></a> e refletem a capacidade de processamento das informa&#231;&#245;es&#46;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">11</span></a> Somente um estudo avaliou a associa&#231;&#227;o entre a IVH e as respostas de habitua&#231;&#227;o a est&#237;mulos externos em neonatos prematuros e os autores n&#227;o encontraram associa&#231;&#227;o entre les&#227;o cerebral e as respostas de habitua&#231;&#227;o&#44; apesar de terem encontrado uma associa&#231;&#227;o entre as les&#245;es cereberais &#40;hemorragia cerebelar&#44; IVH grave ou leucomal&#225;cia periventricular&#41; e menor autorregula&#231;&#227;o e maior excitabilidade&#46;<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">13</span></a> A diferen&#231;a com rela&#231;&#227;o a nossos resultados pode ser devida a uma maior imaturidade e maior frequ&#234;ncia de morbidades neonatais nos pacientes inscritos no primeiro estudo&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">O sistema nervoso central tem um desenvolvimento complexo e cada fun&#231;&#227;o depende da matura&#231;&#227;o do substrato neural anat&#244;mico correspondente&#44; que envolve prolifera&#231;&#227;o&#44; migra&#231;&#227;o&#44; organiza&#231;&#227;o e mieliniza&#231;&#227;o dos neur&#244;nios&#46;<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">24</span></a> Em neonatos prematuros entre 23 e 32 semanas de idade gestacional&#44; a organiza&#231;&#227;o e a mieliniza&#231;&#227;o se desenvolvem rapidamente e qualquer les&#227;o cerebral nesse est&#225;gio pode levar a mudan&#231;as nas respostas de desenvolvimento e comportamentais&#46;<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">25</span></a> Al&#233;m disso&#44; a experi&#234;ncia ambiental&#44; como a natureza nociva da unidade de terapia intensiva neonatal&#44; pode contribuir para os transtornos comportamentais&#46;<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">26</span></a> No desenvolvimento da resposta de habitua&#231;&#227;o&#44; a aten&#231;&#227;o &#233; reduzida&#44; pois o rec&#233;m&#8208;nascido elabora uma representa&#231;&#227;o mental dos est&#237;mulos e eles se tornam menos interessantes&#46;<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">27</span></a> A aten&#231;&#227;o do neonato a um est&#237;mulo a princ&#237;pio aumenta&#44; conforme as informa&#231;&#245;es sobre o est&#237;mulo s&#227;o processadas&#44; e ent&#227;o apresenta queda&#44; conforme o processamento do est&#237;mulo &#233; progressivamente conclu&#237;do&#46;<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">28</span></a> Quando um novo est&#237;mulo &#233; apresentado&#44; o neonato o compara com a representa&#231;&#227;o mental &#40;mem&#243;ria&#41;&#44; consegue discriminar os novos est&#237;mulos&#46;<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">27</span></a> Os neonatos prematuros com IVH podem ter uma fraca organiza&#231;&#227;o e mieliniza&#231;&#227;o dos neur&#244;nios&#44; interferir no processo de representa&#231;&#227;o mental e&#44; talvez&#44; resultar em menor habitua&#231;&#227;o a est&#237;mulos externos&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">N&#227;o foi encontrada diferen&#231;a entre os neonatos prematuros com e sem IVH com rela&#231;&#227;o &#224;s respostas de habitua&#231;&#227;o a est&#237;mulos t&#225;teis&#46; Os est&#237;mulos t&#225;teis e de dor estimulam os receptores mec&#226;nicos da pele e as vias aferentes comuns para o sistema nervoso central e os neonatos prematuros podem ter uma capacidade limitada de se habituar a est&#237;mulos de dor repetitiva&#46;<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">29</span></a> Como esses neonatos s&#227;o expostos a procedimentos de dor repetitiva durante seu tempo de interna&#231;&#227;o&#44; essas experi&#234;ncias aversivas podem interferir em sua capacidade de se habituar a est&#237;mulos t&#225;teis mostrados no presente estudo&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">A principal limita&#231;&#227;o de nosso estudo &#233; o tamanho da amostra&#44; que pode ter reduzido o poder de detectar as diferen&#231;as na resposta de habitua&#231;&#227;o a est&#237;mulos t&#225;teis entre os grupos e limitado a capacidade de controlar outras poss&#237;veis vari&#225;veis de confus&#227;o&#46; Al&#233;m disso&#44; n&#227;o foi poss&#237;vel avaliar as respostas de habitua&#231;&#227;o de neonatos prematuros com hemorragia na matriz germinativa&#44; hemorragia intraventricular&#44; hidrocefalia p&#243;s&#8208;hemorragia ou infarto parenquimatoso hemorr&#225;gico separadamente&#46; A associa&#231;&#227;o entre outras les&#245;es cerebrais&#44; como leucomal&#225;cia periventricular&#44; porencefalia&#44; aumento ventricular ou hemorragia cerebelar&#44;<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">13</span></a> e o comportamento dos neonatos n&#227;o foi avaliada&#44; pois o diagn&#243;stico por imagem da resson&#226;ncia magn&#233;tica n&#227;o foi obtido&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">Em conclus&#227;o&#44; os neonatos prematuros com IVH mostraram uma menor capacidade de se habituar a est&#237;mulos luminosos e sonoros externos &#224;s 36&#8208;38 semanas de idade p&#243;s&#8208;conceptual&#44; em compara&#231;&#227;o com aqueles sem IVH&#44; ajustada para as vari&#225;veis de confus&#227;o&#46; S&#227;o necess&#225;rios estudos adicionais para avaliar se os neonatos prematuros com menor capacidade de respostas de habitua&#231;&#227;o a est&#237;mulos externos ter&#227;o neurodesenvolvimento mais fraco durante a inf&#226;ncia&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Financiamento</span><p id="par0135" class="elsevierStylePara elsevierViewall">O principal pesquisador foi financiado pelo Conselho Nacional de Desenvolvimento Cient&#237;fico e Tecnol&#243;gico &#40;CNPq&#41;&#58; 128349&#47;2015&#8208;8 e 119032&#47;2016&#8208;3&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Conflitos de interesse</span><p id="par0140" class="elsevierStylePara elsevierViewall">Os autores declaram n&#227;o haver conflitos de interesse&#46;</p></span></span>"
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          "palabras" => array:5 [
            0 => "Behavior"
            1 => "Infant"
            2 => "Premature"
            3 => "Neurologic examination"
            4 => "Peri&#47;intraventricular hemorrhage"
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          "titulo" => "Palavras&#8208;chave"
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          "palabras" => array:5 [
            0 => "Comportamento"
            1 => "Neonato"
            2 => "Prematuro"
            3 => "Exame neurol&#243;gico"
            4 => "Hemorragia peri&#47;intraventricular"
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    "resumen" => array:2 [
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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 evaluate the association between intra&#8208;ventricular hemorrhage and habituation responses to external stimuli in preterm infants at 36&#8211;38 weeks post&#8208;conceptual age&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Cross&#8208;sectional study of infants with gestational age &#60;<span class="elsevierStyleHsp" style=""></span>32 weeks&#46; Intra&#8208;ventricular hemorrhage was identified by cranial ultrasonography and classified according to Papile et al&#46; &#40;1978&#41;&#46; The luminous &#40;flashlight&#41;&#44; sound &#40;rattle&#44; bell&#41;&#44; and tactile stimuli were presented&#44; and the responses were scored according to Lester and Tronik &#40;2004&#41;&#46; Habituation response scores were compared between groups by Student&#39;s <span class="elsevierStyleItalic">t</span>&#8208;test&#46; The association between IVH and habituation scores was evaluated by linear regression adjusted for GA&#44; clinical severity score&#44; post&#8208;conceptual age at habituation assessment&#44; sepsis&#44; and bronchopulmonary dysplasia&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Sixty&#8208;five infants were studied&#44; 20 with intra&#8208;ventricular hemorrhage &#40;16 grades I&#47;II&#59; four grades III&#47;IV&#41; and 45 without intra&#8208;ventricular hemorrhage&#46; Infants with intra&#8208;ventricular hemorrhage had lower gestational age &#40;28&#46;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#46;2 vs&#46; 29&#46;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;7 weeks&#41; and birth weight &#40;990<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>305 vs&#46; 1275<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>360<span class="elsevierStyleHsp" style=""></span>g&#41;&#46; Infants with intra&#8208;ventricular hemorrhage at 36&#8211;38 weeks post&#8208;conceptual age had lower habituation scores to light &#40;4&#46;21<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#46;23 vs&#46; 6&#46;09<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#46;44&#41;&#44; rattle &#40;3&#46;84<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#46;12 vs&#46; 6&#46;18<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#46;27&#41;&#44; and bell &#40;3&#46;58<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;74 vs&#46; 5&#46;20<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#46;47&#41; after controlling for confounders&#46; No differences were found for tactile stimulus&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusion</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Infants with gestational age &#60;<span class="elsevierStyleHsp" style=""></span>32 weeks and intra&#8208;ventricular hemorrhage had poorer habituation responses to external stimuli than those without intra&#8208;ventricular hemorrhage at 36&#8211;38 weeks post&#8208;conceptual age&#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">Avaliar a associa&#231;&#227;o entre hemorragia intraventricular e as respostas de habitua&#231;&#227;o a est&#237;mulos externos em neonatos prematuros com idade p&#243;s&#8208;conceptual de 36&#8208;38 semanas&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">M&#233;todos</span><p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">Estudo transversal com neonatos com idade gestacional &#60; 32 semanas&#46; A hemorragia intraventricular foi identificada por ultrassonografia craniana e classificada de acordo com Papile et al&#46; &#40;1978&#41;&#46; Os est&#237;mulos luminosos &#40;lanterna&#41;&#44; sonoros &#40;chocalho&#44; sino&#41; e t&#225;teis foram apresentados e as respostas foram pontuadas de acordo com Lester &#38; Tronik &#40;2004&#41;&#46; Os escores das respostas de habitua&#231;&#227;o foram comparadas entre os grupos pelo teste t de Student&#46; A associa&#231;&#227;o entre a hemorragia intraventricular e os escores de habitua&#231;&#227;o foi avaliada por regress&#227;o linear ajustada para a idade gestacional&#44; escore de gravidade cl&#237;nica&#44; idade p&#243;s-conceptual na avalia&#231;&#227;o da habitua&#231;&#227;o&#44; sepse e displasia broncopulmonar&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">65 neonatos foram estudados&#44; 20 com hemorragia intraventricular &#40;16 graus I&#47;II&#59;4 graus III&#47;IV&#41; e 45 sem hemorragia intraventricular&#46; Os neonatos com hemorragia intraventricular apresentaram menor idade gestacional &#40;28&#44;2 &#177; 2&#44;2 vs&#46; 29&#44;7 &#177; 1&#44;7 semanas&#41; e peso ao nascer &#40;990 &#177; 305 vs&#46; 1275 &#177; 360 g&#41;&#46; Os neonatos com hemorragia intraventricular na idade p&#243;s-conceptual de 36-38 semanas apresentaram escores de habitua&#231;&#227;o menores a luz &#40;4&#44;21 &#177; 2&#44;23 vs&#46; 6&#44;09 &#177; 2&#44;44&#41;&#44; chocalho &#40;3&#44;84 &#177; 2&#44;12 vs&#46; 6&#44;18 &#177; 2&#44;27&#41; e campainha &#40;3&#44;58 &#177; 1&#44;74 vs&#46; 5&#44;20 &#177; 2&#44;47&#41; ap&#243;s controle para vari&#225;veis de confus&#227;o&#46; Nenhuma diferen&#231;a foi encontrada para os est&#237;mulos t&#225;teis&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclus&#227;o</span><p id="spar0095" class="elsevierStyleSimplePara elsevierViewall">Neonatos com idade gestacional &#60; 32 semanas e hemorragia intraventricular apresentaram respostas de habitua&#231;&#227;o piores a est&#237;mulos externos que os sem hemorragia intraventricular&#44; na idade p&#243;s-conceptual de 36-38 semanas&#46;</p></span>"
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                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Sem IVH&#40;n <span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span> 45&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Com IVH&#40;n <span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span> 20&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">valor de p&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Idade materna &#40;anos&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">27&#44;8&#177;8&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">32&#44;3&#177;9&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;071&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Acompanhamento pr&#233;&#8208;natal &#8211; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">44 &#40;97&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20 &#40;100&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hipertens&#227;o durante a gravidez &#8211; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;15&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;15&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Corioamnionite &#8211; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;2&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;10&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;222&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Gesta&#231;&#227;o m&#250;ltipla &#8211; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16 &#40;35&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10 &#40;50&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;289&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Corticoterapia antenatal &#8211; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">42 &#40;93&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16 &#40;80&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;189&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Parto ces&#225;reo &#8211; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">34 &#40;75&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15 &#40;75&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Masculino &#8211; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">25 &#40;55&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 &#40;30&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;066&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#205;ndice de Apgar no 1&#176; minuto&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#44;6&#177;2&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#44;3&#177;2&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;602&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#205;ndice de Apgar no 5&#176; minuto&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&#44;6&#177;0&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&#44;7&#177;1&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;719&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Idade gestacional &#40;semanas&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">29&#44;7&#177;1&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">28&#44;2&#177;2&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;003&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Peso ao nascer &#40;gramas&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1275&#177;360&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">990&#177;305&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;003&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Per&#237;metro cef&#225;lico &#40;cm&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">27&#44;4&#177;2&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">25&#44;9&#177;2&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;035&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Pequeno para a idade gestacional &#8211; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9 &#40;20&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 &#40;30&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;524&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Pontua&#231;&#227;o Snappe&#8208;II&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14&#44;8&#177;13&#44;7<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">23&#44;2&#177;12&#44;8<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;028&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab2155618.png"
              ]
            ]
          ]
          "notaPie" => array:2 [
            0 => array:3 [
              "identificador" => "tblfn0005"
              "etiqueta" => "a"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Dados dispon&#237;veis para 40 pacientes&#46;</p>"
            ]
            1 => array:3 [
              "identificador" => "tblfn0010"
              "etiqueta" => "b"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Dados dispon&#237;veis para 19 pacientes&#46;</p>"
            ]
          ]
        ]
        "descripcion" => array:1 [
          "pt" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Caracter&#237;sticas maternas e neonatais&#44; de acordo com a presen&#231;a de IVH</p>"
        ]
      ]
      1 => array:8 [
        "identificador" => "tbl0010"
        "etiqueta" => "Tabela 2"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at2"
            "detalle" => "Tabela "
            "rol" => "short"
          ]
        ]
        "tabla" => array:3 [
          "leyenda" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">IVH&#44; hemorragia peri&#8208;intraventricular&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Com IVH &#40;n <span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span> 45&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Sem IVH &#40;n <span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span> 20&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">valor de p&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Taquipneia transit&#243;ria &#8211; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&#40;15&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;10&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;710&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">S&#237;ndrome do desconforto respirat&#243;rio &#8211; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">25 &#40;55&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15 &#40;75&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;173&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hipertens&#227;o pulmonar &#8211; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 &#40;8&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;15&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;667&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Persist&#234;ncia do canal arterial &#8211; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14 &#40;31&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;40&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;574&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Displasia broncopulmonar &#8211; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16 &#40;35&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13 &#40;65&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;034&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Apneia &#8211; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">23 &#40;51&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;40&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;435&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Sepse cl&#237;nica &#8211; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;17&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;40&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;068&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Meningite &#8211; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#40;4&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;5&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Enterocolite necrosante &#8211; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;2&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0 &#40;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Retinopatia da prematuridade &#8211; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 &#40;8&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;15&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;667&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Ventila&#231;&#227;o mec&#226;nica &#8211; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18 &#40;40&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16 &#40;80&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;003&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Dias de ventila&#231;&#227;o mec&#226;nica<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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#44;0 &#40;2&#44;0 &#8211; 10&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&#44;5 &#40;5&#44;0 &#8211; 44&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;006&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Surfactante ex&#243;geno &#8211; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16 &#40;35&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13 &#40;65&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;034&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Ibuprofeno &#8211; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 &#40;8&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&#44; &#40;50&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Esteroides p&#243;s&#8208;natal &#8211; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;4&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 &#40;30&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;008&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Analg&#233;sicos ou sedativos &#8211; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11 &#40;55&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 &#40;11&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Emiss&#245;es otoac&#250;sticas ausentes bilateralmente &#8211; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;5&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;4&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;588&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Fun&#231;&#227;o auditiva anormal do tronco encef&#225;lico &#8211; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;15&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;974&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Idade na alta hospitalar &#40;dias&#41;<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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">51&#44;1&#177;22&#44;3&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">73&#44;9&#177;35&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;014&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Idade p&#243;s&#8208;conceitual na alta &#40;semanas&#41;<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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">37&#44;0&#177;2&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">38&#44;7&#177;3&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;037&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Peso na alta hospitalar &#40;gramas&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2405&#177;344&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2565&#177;622&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;291&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Per&#237;metro cef&#225;lico na alta &#40;cm&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">32&#44;4&#177;1&#44;6&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">32&#44;4&#177;1&#44;8&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;926&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="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Sem IVH&#40;n <span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span> 45&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Com IVH&#40;n <span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span> 20&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">valor de p&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Idade no exame &#40;dias&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">47&#44;7&#177;21&#44;6&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">68&#44;0&#177;28&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;002&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Idade p&#243;s&#8208;conceptual no exame &#40;semanas&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">36&#44;5&#177;2&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">37&#44;9&#177;2&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;019&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Estado inicial de sono e vig&#237;lia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;11&#177;0&#44;32&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;25&#177;0&#44;44&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;217&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Estado intermedi&#225;rio de sono e vig&#237;lia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;96&#177;0&#44;56&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;90&#177;0&#44;64&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;726&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Estado final de sono e vig&#237;lia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;33&#177;0&#44;83&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;40&#177;0&#44;99&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Pontua&#231;&#227;o de habitua&#231;&#227;o &#224; luz&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#44;09&#177;2&#44;44&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#44;21&#177;2&#44;23<a class="elsevierStyleCrossRef" href="#tblfn0025"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;005&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Habitua&#231;&#227;o ao est&#237;mulo luminoso &#8211; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">31 &#40;68&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 &#40;26&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;002&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Pontua&#231;&#227;o de habitua&#231;&#227;o ao chocalho&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#44;18&#177;2&#44;27<a class="elsevierStyleCrossRef" href="#tblfn0030"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#44;84&#177;2&#44;12<a class="elsevierStyleCrossRef" href="#tblfn0025"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;004&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Habitua&#231;&#227;o ao chocalho &#8211; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">31 &#40;70&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;15&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Pontua&#231;&#227;o de habitua&#231;&#227;o &#224; campainha&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#44;20&#177;2&#44;47<a class="elsevierStyleCrossRef" href="#tblfn0030"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#44;58&#177;1&#44;74<a class="elsevierStyleCrossRef" href="#tblfn0025"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Habitua&#231;&#227;o &#224; campainha &#8211; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">24 &#40;54&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;15&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;005&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Pontua&#231;&#227;o de habitua&#231;&#227;o ao est&#237;mulo t&#225;til&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#44;98&#177;2&#44;27<a class="elsevierStyleCrossRef" href="#tblfn0030"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#44;30&#177;2&#44;34&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;277&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Pontua&#231;&#227;o de habitua&#231;&#227;o &#224; luz&#44; ao chocalho e &#224; campainha&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#44;80&#177;1&#44;85&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#44;88&#177;1&#44;79&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Habitua&#231;&#227;o &#224; luz&#44; ao chocalho e &#224; campainha &#8211; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">31 &#40;68&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 &#40;21&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;001&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
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Coeficiente B &#40;IC de 95&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">valor de p&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Habitua&#231;&#227;o &#224; luz &#8211; p <span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span> 0&#44;012&#59; r<span class="elsevierStyleSup">2</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span> 0&#44;116&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">IVH&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;1&#44;465 &#40;&#8722;2&#44;893&#59; &#8722;0&#44;037&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;044&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Sepse&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;1&#44;256 &#40;&#8722;2&#44;734&#59; 0&#44;222&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;094&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Habitua&#231;&#227;o ao chocalho &#8211; p <span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span> 0&#44;001&#59; r<span class="elsevierStyleSup">2</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span> 0&#44;176&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">IVH&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;2&#44;291 &#40;&#8722;3&#44;584&#59; &#8722;1&#44;017&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Habitua&#231;&#227;o &#224; campainha &#8211; p <span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span> 0&#44;011&#59; r<span class="elsevierStyleSup">2</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span> 0&#44;095&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">IVH&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;1&#44;697 &#40;&#8722;2&#44;996&#59; &#8722;0&#44;398&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Habitua&#231;&#227;o &#224; luz&#44; ao chocalho e &#224; campainha &#8211; p <span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span> 0&#44;001&#59; r<span class="elsevierStyleSup">2</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span> 0&#44;167&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">IVH&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">Habitua&#231;&#227;o &#224; luz&#44; ao chocalho&#44; &#224; campainha e ao est&#237;mulo t&#225;til &#8211; p <span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span> 0&#44;001&#59; r<span class="elsevierStyleSup">2</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span> 0&#44;159&nbsp;\t\t\t\t\t\t\n
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          "pt" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Associa&#231;&#227;o entre as pontua&#231;&#245;es de IVH e habitua&#231;&#227;o por meio da an&#225;lise de regress&#227;o linear m&#250;ltipla</p>"
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      "titulo" => "Refer&#234;ncias"
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Preterm infants with peri/intraventricular hemorrhage have poorer habituation responses to external stimuli
Neonatos prematuros com hemorragia peri‐intraventricular apresentam respostas de habituação piores a estímulos externos
Gabrielle Greice Garcia Buenoa, Marina Carvalho de Moraes Barrosb,
Autor para correspondência
marinamoraesbarros@uol.com.br

Autor para correspondência.
, Ruth Guinsburgb
a Universidade Federal de São Paulo (Unifesp), Escola Paulista de Medicina (EPM), São Paulo, SP, Brasil
b Universidade Federal de São Paulo (Unifesp), Departamento de Pediatria, Divisão de Pediatria Neonatal, São Paulo, SP, Brasil
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Grau III &#8211; 3&#44;3&#37; &#40;IC de 95&#37; 2&#44;7&#8208;3&#44;9&#41; e Grau IV &#8211; 3&#44;8&#37; &#40;IC de 95&#37; 3&#44;2&#8208;4&#44;5&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">3</span></a> Em um estudo prospectivo multic&#234;ntrico de neonatos prematuros &#60;<span class="elsevierStyleHsp" style=""></span>32 semanas de idade gestacional nascidos em 10 hospitais americanos&#44; os graus III&#47;IV de IVH estiveram presentes em 5&#37; deles&#46;<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">4</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">A associa&#231;&#227;o de IVH e comprometimento moderado ou grave do desenvolvimento neurol&#243;gico &#40;NDI&#58; paralisia cerebral moderada ou grave&#44; atraso cognitivo moderado ou grave&#44; comprometimento visual grave e&#47;ou comprometimento grave da audi&#231;&#227;o&#41; aos 18&#8208;24 meses corrigida dos neonatos com idade gestacional &#60;<span class="elsevierStyleHsp" style=""></span>34 semanas foi avaliada por metan&#225;lise&#46; Entre os sobreviventes e o ajuste para as vari&#225;veis de confus&#227;o&#44; o NDI foi maior em neonatos prematuros com IVH leve &#40;Graus I&#47;II&#41; em compara&#231;&#227;o com os sem IVH &#40;RC 1&#44;34&#59; IC de 95&#37; 1&#44;09&#8208;1&#44;77&#44; nos com IVH grave &#40;Graus III&#47;IV&#41; em compara&#231;&#227;o com os sem IVH &#40;RC 2&#44;44&#59; IC de 95&#37; 1&#44;73&#8208;3&#44;42&#41; e nos com IVH grave em compara&#231;&#227;o com leve &#40;RC 2&#44;16&#59; IC de 95&#37; 2&#44;36&#8208;3&#44;45&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">5</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Recentemente&#44; alguns estudos mostraram uma associa&#231;&#227;o entre o neurocomportamento menos ideal em neonatos prematuros avaliados a termo&#44; com idade corrigida pela Escala Neurocomportamental da Rede de Unidades de Terapia Intensiva Neonatal &#40;UTIN&#41; &#40;NNNS&#41;&#44;<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">6</span></a> e o atraso no desenvolvimento na inf&#226;ncia&#46;<a class="elsevierStyleCrossRefs" href="#bib0180"><span class="elsevierStyleSup">7&#44;8</span></a> Ela considera n&#227;o somente o estado organizacional do pacientes&#44; mas tamb&#233;m os limites dessa organiza&#231;&#227;o&#44; que podem ser testados por meio de situa&#231;&#245;es de estresse&#46; A integridade dos sistemas de modula&#231;&#227;o permite a organiza&#231;&#227;o de respostas comportamentais a situa&#231;&#245;es de estresse&#46;<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">9</span></a> Um dos dom&#237;nios da avalia&#231;&#227;o neurocomportamental &#233; a resposta de habitua&#231;&#227;o&#44; que testa as compet&#234;ncias perceptivas e cognitivas no per&#237;odo neonatal&#46;<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">10</span></a> As pontua&#231;&#245;es de habitua&#231;&#227;o avaliam a capacidade de o neonato diminuir ou abolir a resposta a um est&#237;mulo quando presente por um longo per&#237;odo ou por v&#225;rios curtos per&#237;odos repetidos&#59; contudo&#44; quando um est&#237;mulo novo &#233; mostrado&#44; a aten&#231;&#227;o do neonato ao est&#237;mulo aumentar&#225; posteriormente&#46; Esse padr&#227;o de resposta reflete a capacidade de processamento de informa&#231;&#245;es&#46; O atraso na resposta de habitua&#231;&#227;o a est&#237;mulos externos significa uma menor capacidade de modular a resposta comportamental a um est&#237;mulo de estresse&#46;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">11</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">Poucos estudos examinaram as respostas de habitua&#231;&#227;o em neonatos prematuros a termo e os resultados s&#227;o contradit&#243;rios&#46; Castillo et al&#46; avaliaram neonatos prematuros &#60;<span class="elsevierStyleHsp" style=""></span>32 semanas de gesta&#231;&#227;o prospectivamente e&#44; a termo&#44; eles apresentaram respostas de habitua&#231;&#227;o semelhantes em compara&#231;&#227;o com os nascidos a termo avaliados nos primeiros dias de vida&#46;<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">12</span></a> Pineda et al&#46; constataram que os neonatos prematuros&#44; a termo&#44; apresentaram respostas de habitua&#231;&#227;o piores em compara&#231;&#227;o com os neonatos a termo&#46;<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">13</span></a> A literatura sobre a associa&#231;&#227;o entre o dano cerebral e o neurocomportamento de neonatos prematuros a termo com idade corrigida com o uso da NNNS &#233; escassa&#46; Nos estudos existentes&#44; a IVH grave foi associada a menos aten&#231;&#227;o&#44; mais excitabilidade e maior n&#250;mero de respostas n&#227;o ideais quando os reflexos s&#227;o testados&#46;<a class="elsevierStyleCrossRefs" href="#bib0210"><span class="elsevierStyleSup">13&#44;14</span></a> Somente Pineda et al&#46; avaliaram a associa&#231;&#227;o entre o dano cerebral e as respostas de habitua&#231;&#227;o e n&#227;o encontraram associa&#231;&#227;o&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Nesse contexto&#44; o objetivo deste estudo &#233; avaliar a associa&#231;&#227;o entre a IVH e as respostas de habitua&#231;&#227;o a est&#237;mulos externos em neonatos prematuros &#60;<span class="elsevierStyleHsp" style=""></span>32 semanas de idade gestacional&#44; &#224;s 36&#8208;38 semanas de idade gestacional corrigida&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Material e m&#233;todos</span><p id="par0030" class="elsevierStylePara elsevierViewall">Este &#233; um estudo transversal com neonatos prematuros nascidos em um hospital universit&#225;rio p&#250;blico terci&#225;rio em S&#227;o Paulo&#44; Brasil&#44; entre junho de 2015 e mar&#231;o de 2017&#46; O estudo foi aprovado pelo Comit&#234; de &#201;tica da institui&#231;&#227;o &#40;CAAE 44415915&#46;0&#46;0000&#46;5505&#41;&#46; Os neonatos rec&#233;m&#8208;nascidos foram inscritos para participar ap&#243;s seus pais assinarem o formul&#225;rio de consentimento informado&#46; Inclu&#237;mos consecutivamente neonatos prematuros com idade gestacional abaixo &#60;<span class="elsevierStyleHsp" style=""></span>32 semanas&#44; 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treinado por um pesquisador certificado para fazer a NNNS no Hospital da Ilha de Rodes&#44; Brown University&#44; RI&#44; de acordo com o Estudo de Estilo de Vida Materno&#46;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">15</span></a> O exame neurocomportamental teve in&#237;cio com a observa&#231;&#227;o do estado de sono&#8208;vig&#237;lia e a avalia&#231;&#227;o das respostas de habitua&#231;&#227;o a est&#237;mulos externos teve in&#237;cio somente quando o paciente estava no estado de sono&#8208;vig&#237;lia exigido para cada teste&#46;<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">6</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">Os est&#237;mulos externos foram apresentados sempre na mesma ordem&#58; est&#237;mulo luminoso &#40;uma lanterna padr&#227;o de oito polegadas foi aluminada 30<span class="elsevierStyleHsp" style=""></span>cm do neonato&#44; diretamente nos olhos por dois segundos&#41;&#59; est&#237;mulo auditivo &#8211; chocalho e campainha &#40;o chocalho foi agitado duas vezes a 30<span class="elsevierStyleHsp" style=""></span>cm do neonato e&#44; ap&#243;s isso&#44; a mesma a&#231;&#227;o foi feita com a campainha&#41;&#59; est&#237;mulos t&#225;teis &#40;o calcanhar foi pressionado de forma suave&#44; por&#233;m firme&#44; com um bast&#227;o pl&#225;stico&#41;&#46; Os est&#237;mulos luminosos e auditivos foram apresentados at&#233; dez vezes e os est&#237;mulos t&#225;teis foram apresentados at&#233; cinco vezes&#46; O pr&#243;ximo est&#237;mulo foi apresentado cinco segundos ap&#243;s o neonato cessar a resposta&#46; Para pontuar a resposta&#44; o est&#237;mulo ao qual o neonato respondeu primeiro foi considerado a apresenta&#231;&#227;o inicial&#46; Caso&#44; ap&#243;s duas tentativas&#44; ainda n&#227;o tivesse havido resposta ou caso a resposta do neonato ao est&#237;mulo tivesse durado mais de 45 segundos&#44; foi aplicado o pr&#243;ximo item de habitua&#231;&#227;o&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">A resposta de habitua&#231;&#227;o foi avaliada com base na capacidade de o neonato cessar&#44; diminuir ou atrasar suas respostas &#224; apresenta&#231;&#227;o repetida de um est&#237;mulo&#46; A resposta foi considerada presente se o neonato mostrou movimenta&#231;&#227;o de todo o corpo ou do membro&#44; movimentos de contor&#231;&#227;o ou piscar de olhos com caretas faciais&#46; As respostas foram pontuadas como segue&#58; 1 &#8211; nenhum decr&#233;scimo nas respostas nos 10 est&#237;mulos&#59; 2 &#8211; nenhum decr&#233;scimo nas respostas&#44; por&#233;m algum atraso nas repostas nas 10 tentativas&#59; 3 &#8211; algum decr&#233;scimo nas respostas nas 10 tentativas&#44; por&#233;m n&#227;o cessou completamente&#59; 4 &#8211; algum decr&#233;scimo nas respostas e atraso nas respostas nas 10 tentativas&#44; por&#233;m n&#227;o cessou completamente&#59; 5 &#8211; cessou as respostas ap&#243;s nove est&#237;mulos&#59; 6 &#8211; cessou as respostas ap&#243;s 7&#8208;8 est&#237;mulos&#59; 7 &#8211; cessou as respostas ap&#243;s 5&#8208;6 est&#237;mulos&#59; 8 &#8211; cessou as respostas ap&#243;s 3&#8208;4 est&#237;mulos&#59; 9 &#8211; cessou as respostas ap&#243;s 1&#8208;2 est&#237;mulos&#46; As pontua&#231;&#245;es 5&#8208;9 indicam habitua&#231;&#227;o bem&#8208;sucedida e as pontua&#231;&#245;es 4 ou menores foram consideradas decr&#233;scimo nas respostas incompletas&#46;<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">6</span></a></p><p id="par0055" class="elsevierStylePara elsevierViewall">Para est&#237;mulos t&#225;teis&#44; as respostas de habitua&#231;&#227;o foram pontuadas como segue&#58; 1 &#8211; resposta generalizada em todo o corpo e aumentou com as tentativas&#59; 2 &#8211; os dois p&#233;s foram retirados sem decr&#233;scimo na resposta&#59; 3 &#8211; resposta vari&#225;vel aos est&#237;mulos com decr&#233;scimo nas respostas&#59; 4 &#8211; decr&#233;scimo nas respostas ap&#243;s 5 tentativas localizadas a est&#237;mulos nas pernas e nenhuma mudan&#231;a no estado de alerta&#59; 5 &#8211; decr&#233;scimo nas respostas ap&#243;s 5 tentativas localizadas a est&#237;mulos nos p&#233;s e nenhuma mudan&#231;a no estado de alerta&#59; 6 &#8211; resposta limitada a est&#237;mulos nos p&#233;s ap&#243;s 3&#8208;4 tentativas e nenhuma mudan&#231;a no estado de alerta&#59; 7 &#8211; resposta limitada a est&#237;mulos nos p&#233;s ou decr&#233;scimo total na resposta ap&#243;s 1&#8208;2 tentativas e nenhuma mudan&#231;a no estado de alerta&#59; 8 &#8211; resposta localizada e m&#237;nima ap&#243;s duas tentativas e mudan&#231;a no estado de alerta&#59; 9 &#8211; decr&#233;scimo total nas respostas e mudan&#231;a no estado de alerta&#46; Para habitua&#231;&#227;o a est&#237;mulos t&#225;teis&#44; n&#227;o h&#225; defini&#231;&#227;o da pontua&#231;&#227;o acima na qual a habitua&#231;&#227;o &#233; considerada presente&#46;<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">6</span></a></p><p id="par0060" class="elsevierStylePara elsevierViewall">Os seguintes dados foram coletados&#58; caracter&#237;sticas maternas&#44; caracter&#237;sticas demogr&#225;ficas neonatais&#44; ao Escore para Fisiologia Neonatal Aguda &#8211; Extens&#227;o Perinatal &#40;Snappe&#8208;II&#41;<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">16</span></a> e morbidez durante o tempo de interna&#231;&#227;o&#46; As interven&#231;&#245;es terap&#234;uticas&#44; como ventila&#231;&#227;o mec&#226;nica &#40;presen&#231;a e n&#250;mero de dias&#41;&#44; surfactante ex&#243;geno&#44; ibuprofeno&#44; analg&#233;sicos&#44; sedativos e uso p&#243;s&#8208;natal de esteroides&#44; tamb&#233;m foram coletadas&#46; Na alta&#44; os dados estudados inclu&#237;ram&#58; idade cronol&#243;gica&#44; idade p&#243;s&#8208;conceptual&#44; peso e per&#237;metro cef&#225;lico&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">O tamanho da amostra necess&#225;rio para detectar uma diferen&#231;a m&#233;dia de 1 ponto nas pontua&#231;&#245;es de habitua&#231;&#227;o entre os neonatos prematuros com e sem IVH&#44; com desvio padr&#227;o de 1&#44; erro alfa de 5&#37; e poder de 80&#37;&#44; foi de 16 rec&#233;m&#8208;nascidos em cada grupo&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">As pontua&#231;&#245;es das respostas de habitua&#231;&#227;o foram comparadas entre os grupos pelo teste <span class="elsevierStyleItalic">t</span> de Student&#46; Quatro modelos de regress&#227;o linear m&#250;ltipla foram criados com pontua&#231;&#245;es de habitua&#231;&#227;o para os est&#237;mulos de luz&#44; chocalho&#44; campainha e t&#225;teis como as vari&#225;veis dependentes e IVH como uma vari&#225;vel independente e ajustados para os seguintes vari&#225;veis de confus&#227;o&#58; idade gestacional&#44; idade na avalia&#231;&#227;o da habitua&#231;&#227;o&#44; sepse cl&#237;nica&#44; displasia broncopulmonar &#40;depend&#234;ncia de oxig&#234;nio com 28 dias&#41; e escore Snappe&#8208;II &#62; 15 &#40;pontua&#231;&#227;o m&#233;dia da popula&#231;&#227;o estudada&#41;&#44; presumiu&#8208;se o n&#250;mero m&#237;nimo de 10 pacientes para cada fator inclu&#237;do na an&#225;lise&#46; A an&#225;lise foi feita com o SPSS &#40;Pacote SPSS Statistics para Windows&#44; vers&#227;o 20&#46;0&#44; IBM&#44; Somers&#44; NY&#44; EUA&#41;&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Resultados</span><p id="par0075" class="elsevierStylePara elsevierViewall">De junho de 2015 a mar&#231;o de 2017&#44; 130 neonatos prematuros com idade gestacional &#60;<span class="elsevierStyleHsp" style=""></span>32 semanas nasceram no hospital do estudo&#46; Entre esses&#44; 65 atenderam a um ou mais crit&#233;rios de exclus&#227;o&#58; malforma&#231;&#245;es cong&#234;nitas &#40;27&#41;&#44; infec&#231;&#245;es cong&#234;nitas &#40;5&#41;&#44; &#243;bito durante a interna&#231;&#227;o &#40;23&#41;&#44; recusa a participar do estudo &#40;6&#41; e n&#227;o avaliado &#40;4&#41;&#46; Portanto&#44; 65 beb&#234;s foram estudados&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">Os neonatos prematuros fizeram uma m&#233;dia de 3&#44;1 &#177; 1&#44;5 &#40;varia&#231;&#227;o&#58; 1&#8208;9&#41; ultrassonografias de cabe&#231;a durante o tempo de interna&#231;&#227;o&#46; O primeiro exame foi feito em todos os 65 neonatos&#44; com mediana de 5 &#40;1&#8208;17&#41; dias ap&#243;s o nascimento&#59; 59 &#40;91&#37;&#41; fizeram dois exames com 13 &#40;6&#8208;39&#41; dias de vida&#59; 38 &#40;58&#37;&#41; fizeram tr&#234;s exames com 26 &#40;12&#8208;52&#41; dias&#59; 21 &#40;32&#37;&#41; fizeram quatro exames com 32 &#40;17&#8208;69&#41; dias de vida&#59; 9 &#40;14&#37;&#41; fizeram cinco exames com 41 &#40;30&#8208;58&#41; dias de vida&#59; e 8 &#40;12&#37;&#41; neonatos fizeram mais de cinco exames durante o tempo de interna&#231;&#227;o&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">IVH foi identificada em 20 &#40;30&#44;8&#37;&#41; neonatos&#44; grau I em 12 &#40;60&#44;0&#37;&#41;&#44; grau II em 4 &#40;20&#44;0&#37;&#41;&#44; grau III em 2 &#40;10&#44;0&#37;&#41; e grau IV em 2 &#40;10&#44;0&#37;&#41;&#46; Em 11 neonatos &#40;55&#37;&#41;&#44; o diagn&#243;stico de IVH foi feito nos primeiros 10 dias de vida&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">As caracter&#237;sticas demogr&#225;ficas e cl&#237;nicas das m&#227;es e dos neonatos com e sem IVH foram semelhantes&#44; exceto que os neonatos prematuros com IVH&#44; em compara&#231;&#227;o com os sem IVH&#44; apresentaram menor idade gestacional&#44; peso ao nascer e per&#237;metro cef&#225;lico no nascimento e um escore Snappe&#8208;II maior &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">tabela 1</a>&#41;&#46; Somente uma m&#227;e em cada grupo fez uso de maconha durante a gesta&#231;&#227;o&#46; A <a class="elsevierStyleCrossRef" href="#tbl0010">tabela 2</a> mostra a morbidez e as interven&#231;&#245;es terap&#234;uticas recebidas durante o tempo de interna&#231;&#227;o&#46; Os neonatos com IVH usaram ibuprofeno e sedativos e&#47;ou analg&#233;sicos com mais frequ&#234;ncia do que os sem IVH&#59; contudo&#44; eles n&#227;o usaram qualquer desses medicamentos no momento do exame neurocomportamental&#46; Apesar de tr&#234;s neonatos n&#227;o terem apresentado emiss&#245;es otoac&#250;sticas bilaterais e de oito terem apresentado fun&#231;&#227;o auditiva anormal do tronco encef&#225;lico auditivo&#44; seu limiar tonal foi entre 40&#8208;50<span class="elsevierStyleHsp" style=""></span>dB&#46; Como a intensidade do som do chocalho e da campainha &#233; de 90&#8208;100<span class="elsevierStyleHsp" style=""></span>dB&#44; os neonatos conseguiram escutar o chocalho e a campainha&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0095" class="elsevierStylePara elsevierViewall">A <a class="elsevierStyleCrossRef" href="#tbl0015">tabela 3</a> mostra as respostas de habitua&#231;&#227;o dos neonatos a est&#237;mulos externos&#46; A avalia&#231;&#227;o foi feita em uma idade p&#243;s&#8208;natal e p&#243;s&#8208;conceptual mais avan&#231;ada em neonatos prematuros com IVH&#46; N&#227;o foi encontrada diferen&#231;a entre os neonatos com e sem IVH com rela&#231;&#227;o ao tempo ap&#243;s a &#250;ltima alimenta&#231;&#227;o na avalia&#231;&#227;o &#40;66 &#177; 21 em compara&#231;&#227;o com 69 &#177; 46 minutos&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;701&#41; ou a dura&#231;&#227;o do exame &#40;13 &#177; 4 em compara&#231;&#227;o com 13 &#177; 5 minutos&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;812&#41;&#46; Os neonatos prematuros com IVH apresentaram menores pontua&#231;&#245;es de habitua&#231;&#227;o a luz e som&#44; por&#233;m nenhuma diferen&#231;a nos est&#237;mulos t&#225;teis&#46; Os neonatos prematuros sem IVH apresentaram uma resposta de habitua&#231;&#227;o completa a luz e som ap&#243;s 7&#8208;8 est&#237;mulos&#44; ao passo que os com IVH mostraram uma redu&#231;&#227;o e atraso na reposta ao est&#237;mulo&#44; por&#233;m habitua&#231;&#227;o incompleta&#46; Ao comparar a frequ&#234;ncia de sucesso na resposta de habitua&#231;&#227;o a luz e som&#44; isso foi menos frequente em neonatos com IVH&#44; em compara&#231;&#227;o com os sem IVH&#46; A associa&#231;&#227;o entre a presen&#231;a de IVH e a varia&#231;&#227;o das respostas de habitua&#231;&#227;o aos diferentes est&#237;mulos mostrou que a IVH foi associada &#224; redu&#231;&#227;o nas pontua&#231;&#245;es de habitua&#231;&#227;o a luz e som&#44; mesmo ap&#243;s controlar a idade gestacional no nascimento&#44; idade na avalia&#231;&#227;o comportamental&#44; sepse cl&#237;nica&#44; displasia broncopulmonar e o escore de gravidade Snappe&#8208;II &#40;<a class="elsevierStyleCrossRef" href="#tbl0020">tabela 4</a>&#41;&#46; A IVH n&#227;o foi associada &#224; pontua&#231;&#227;o de habitua&#231;&#227;o aos est&#237;mulos t&#225;teis&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><elsevierMultimedia ident="tbl0020"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Discuss&#227;o</span><p id="par0100" class="elsevierStylePara elsevierViewall">Os neonatos prematuros &#60;<span class="elsevierStyleHsp" style=""></span>32 semanas de gesta&#231;&#227;o com IVH&#44; quando examinados antes da alta hospitalar&#44; apresentaram menos respostas de habitua&#231;&#227;o a est&#237;mulos luminosos e sonoros externos&#44; em compara&#231;&#227;o com os sem IVH&#46; Deve&#8208;se notar que os neonatos com IVH foram avaliados em uma idade corrigida de 37&#44;9 semanas e aqueles sem IVH &#224;s 36&#44;5 semanas&#46; Isso aconteceu porque os neonatos com IVH foram internados por per&#237;odos mais longos&#44; pois eles eram mais imaturos e mais doentes&#44; e os dois grupos foram avaliados pr&#243;ximo &#224; alta hospitalar&#46; Portanto&#44; a an&#225;lise m&#250;ltipla foi ajustada para essas poss&#237;veis vari&#225;veis de confus&#227;o&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">IVH foi identificada em 30&#44;8&#37; dos neonatos prematuros&#44; 80&#37; leve e 20&#37; grave&#46; O Projeto de Base de Dados da Vermont Oxford Trial Network relatou uma frequ&#234;ncia de IVH de 26&#37; entre neonatos prematuros com muito baixo peso ao nascer internados em 38 unidades neonatais da Am&#233;rica do Norte&#46;<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">17</span></a> Mais recentemente&#44; o Instituto Nacional de Sa&#250;de Infantil e Desenvolvimento Humano Rede de Pesquisa Neonatal Eunice Kennedy Shriver mostrou uma incid&#234;ncia de IVH grave de 5&#37; em neonatos com &#60;<span class="elsevierStyleHsp" style=""></span>28 semanas de idade gestacional&#46;<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">1</span></a> Em 20 hospitais universit&#225;rios p&#250;blicos brasileiros&#44; identificamos IVH grave em 10&#37; dos neonatos prematuros com idade gestacional de 23 a 33 semanas&#46;<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">18</span></a> Uso mais frequente de corticoterapia antenatal e melhores pr&#225;ticas no cuidado neonatal no Brasil ainda s&#227;o necess&#225;rios para reduzir a frequ&#234;ncia da IVH em neonatos prematuros&#46;<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">18</span></a></p><p id="par0110" class="elsevierStylePara elsevierViewall">Estudos mostraram que a IVH est&#225; associada a um pior desenvolvimento global na inf&#226;ncia&#46;<a class="elsevierStyleCrossRefs" href="#bib0180"><span class="elsevierStyleSup">7&#44;8</span></a> Em neonatos extremamente prematuros&#44; aqueles com hemorragia intraventricular grau III&#8208;IV&#44; em compara&#231;&#227;o com aqueles sem IVH&#44; apresentam maiores taxas de atraso no desenvolvimento &#40;43&#44;0&#37; em compara&#231;&#227;o com 12&#44;1&#37;&#41;&#44; paralisia cerebral &#40;30&#44;1&#37; em compara&#231;&#227;o com 6&#44;5&#37;&#41;&#44; surdez &#40;8&#44;6&#37; em compara&#231;&#227;o com 2&#44;3&#37;&#41; e cegueira &#40;2&#44;2&#37; em compara&#231;&#227;o com 0&#44;2&#37;&#41;&#46; A alta frequ&#234;ncia de comprometimento do desenvolvimento tamb&#233;m foi encontrada em neonatos com IVH graus I&#8208;II&#44; em compara&#231;&#227;o com aqueles sem IVH&#58; &#40;22&#44;0&#37; em compara&#231;&#227;o com 12&#44;1&#37;&#41;&#44; paralisia cerebral &#40;10&#44;4&#37; em compara&#231;&#227;o com 6&#44;5&#37;&#41; e surdez &#40;6&#44;0&#37; em compara&#231;&#227;o com 2&#44;3&#37;&#41;&#46; Mesmos ap&#243;s a exclus&#227;o de outras anomalias no ultrassom&#44; inclusive leucomal&#225;cia&#44; porencefalia e aumento ventricular&#44; a IVH graus I&#8208;II isolada foi associada ao aumento nas taxas de comprometimento neurossensorial moderado&#8208;grave &#40;18&#44;6&#37; em compara&#231;&#227;o com 12&#44;1&#37;&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">19</span></a> Em outro estudo&#44; os neonatos com peso ao nascer &#60;<span class="elsevierStyleHsp" style=""></span>1&#46;000<span class="elsevierStyleHsp" style=""></span>g e IVH graus I&#47;II apresentaram uma maior frequ&#234;ncia de MDI &#60;<span class="elsevierStyleHsp" style=""></span>70 e anormalidades motoras e neurossensoriais em compara&#231;&#227;o com aqueles sem IVH&#46;<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">20</span></a> Outro estudo tamb&#233;m mostrou que&#44; mesmo quando a resson&#226;ncia magn&#233;tica cerebral foi normal&#44; neonatos extremamente prematuros apresentam desempenho cognitivo e motor mais baixo aos 30 meses de idade corrigida em compara&#231;&#227;o com os neonatos nascidos a termo&#46;<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">21</span></a> Como as mudan&#231;as comportamentais nos neonatos prematuros avaliados em idade p&#243;s&#8208;conceptual a termo tamb&#233;m s&#227;o associadas a um desenvolvimento mais baixo na inf&#226;ncia&#44;<a class="elsevierStyleCrossRefs" href="#bib0180"><span class="elsevierStyleSup">7&#44;8&#44;22&#44;23</span></a> &#233; interessante identificar as caracter&#237;sticas neurocomportamentais dos neonatos prematuros com les&#245;es cerebrais&#46; As respostas de habitua&#231;&#227;o s&#227;o um dom&#237;nio importante do neurocomportamento neonatal&#44; pois elas avaliam as compet&#234;ncias de percep&#231;&#227;o e cognitivas<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">10</span></a> e refletem a capacidade de processamento das informa&#231;&#245;es&#46;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">11</span></a> Somente um estudo avaliou a associa&#231;&#227;o entre a IVH e as respostas de habitua&#231;&#227;o a est&#237;mulos externos em neonatos prematuros e os autores n&#227;o encontraram associa&#231;&#227;o entre les&#227;o cerebral e as respostas de habitua&#231;&#227;o&#44; apesar de terem encontrado uma associa&#231;&#227;o entre as les&#245;es cereberais &#40;hemorragia cerebelar&#44; IVH grave ou leucomal&#225;cia periventricular&#41; e menor autorregula&#231;&#227;o e maior excitabilidade&#46;<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">13</span></a> A diferen&#231;a com rela&#231;&#227;o a nossos resultados pode ser devida a uma maior imaturidade e maior frequ&#234;ncia de morbidades neonatais nos pacientes inscritos no primeiro estudo&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">O sistema nervoso central tem um desenvolvimento complexo e cada fun&#231;&#227;o depende da matura&#231;&#227;o do substrato neural anat&#244;mico correspondente&#44; que envolve prolifera&#231;&#227;o&#44; migra&#231;&#227;o&#44; organiza&#231;&#227;o e mieliniza&#231;&#227;o dos neur&#244;nios&#46;<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">24</span></a> Em neonatos prematuros entre 23 e 32 semanas de idade gestacional&#44; a organiza&#231;&#227;o e a mieliniza&#231;&#227;o se desenvolvem rapidamente e qualquer les&#227;o cerebral nesse est&#225;gio pode levar a mudan&#231;as nas respostas de desenvolvimento e comportamentais&#46;<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">25</span></a> Al&#233;m disso&#44; a experi&#234;ncia ambiental&#44; como a natureza nociva da unidade de terapia intensiva neonatal&#44; pode contribuir para os transtornos comportamentais&#46;<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">26</span></a> No desenvolvimento da resposta de habitua&#231;&#227;o&#44; a aten&#231;&#227;o &#233; reduzida&#44; pois o rec&#233;m&#8208;nascido elabora uma representa&#231;&#227;o mental dos est&#237;mulos e eles se tornam menos interessantes&#46;<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">27</span></a> A aten&#231;&#227;o do neonato a um est&#237;mulo a princ&#237;pio aumenta&#44; conforme as informa&#231;&#245;es sobre o est&#237;mulo s&#227;o processadas&#44; e ent&#227;o apresenta queda&#44; conforme o processamento do est&#237;mulo &#233; progressivamente conclu&#237;do&#46;<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">28</span></a> Quando um novo est&#237;mulo &#233; apresentado&#44; o neonato o compara com a representa&#231;&#227;o mental &#40;mem&#243;ria&#41;&#44; consegue discriminar os novos est&#237;mulos&#46;<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">27</span></a> Os neonatos prematuros com IVH podem ter uma fraca organiza&#231;&#227;o e mieliniza&#231;&#227;o dos neur&#244;nios&#44; interferir no processo de representa&#231;&#227;o mental e&#44; talvez&#44; resultar em menor habitua&#231;&#227;o a est&#237;mulos externos&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">N&#227;o foi encontrada diferen&#231;a entre os neonatos prematuros com e sem IVH com rela&#231;&#227;o &#224;s respostas de habitua&#231;&#227;o a est&#237;mulos t&#225;teis&#46; Os est&#237;mulos t&#225;teis e de dor estimulam os receptores mec&#226;nicos da pele e as vias aferentes comuns para o sistema nervoso central e os neonatos prematuros podem ter uma capacidade limitada de se habituar a est&#237;mulos de dor repetitiva&#46;<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">29</span></a> Como esses neonatos s&#227;o expostos a procedimentos de dor repetitiva durante seu tempo de interna&#231;&#227;o&#44; essas experi&#234;ncias aversivas podem interferir em sua capacidade de se habituar a est&#237;mulos t&#225;teis mostrados no presente estudo&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">A principal limita&#231;&#227;o de nosso estudo &#233; o tamanho da amostra&#44; que pode ter reduzido o poder de detectar as diferen&#231;as na resposta de habitua&#231;&#227;o a est&#237;mulos t&#225;teis entre os grupos e limitado a capacidade de controlar outras poss&#237;veis vari&#225;veis de confus&#227;o&#46; Al&#233;m disso&#44; n&#227;o foi poss&#237;vel avaliar as respostas de habitua&#231;&#227;o de neonatos prematuros com hemorragia na matriz germinativa&#44; hemorragia intraventricular&#44; hidrocefalia p&#243;s&#8208;hemorragia ou infarto parenquimatoso hemorr&#225;gico separadamente&#46; A associa&#231;&#227;o entre outras les&#245;es cerebrais&#44; como leucomal&#225;cia periventricular&#44; porencefalia&#44; aumento ventricular ou hemorragia cerebelar&#44;<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">13</span></a> e o comportamento dos neonatos n&#227;o foi avaliada&#44; pois o diagn&#243;stico por imagem da resson&#226;ncia magn&#233;tica n&#227;o foi obtido&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">Em conclus&#227;o&#44; os neonatos prematuros com IVH mostraram uma menor capacidade de se habituar a est&#237;mulos luminosos e sonoros externos &#224;s 36&#8208;38 semanas de idade p&#243;s&#8208;conceptual&#44; em compara&#231;&#227;o com aqueles sem IVH&#44; ajustada para as vari&#225;veis de confus&#227;o&#46; S&#227;o necess&#225;rios estudos adicionais para avaliar se os neonatos prematuros com menor capacidade de respostas de habitua&#231;&#227;o a est&#237;mulos externos ter&#227;o neurodesenvolvimento mais fraco durante a inf&#226;ncia&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Financiamento</span><p id="par0135" class="elsevierStylePara elsevierViewall">O principal pesquisador foi financiado pelo Conselho Nacional de Desenvolvimento Cient&#237;fico e Tecnol&#243;gico &#40;CNPq&#41;&#58; 128349&#47;2015&#8208;8 e 119032&#47;2016&#8208;3&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Conflitos de interesse</span><p id="par0140" class="elsevierStylePara elsevierViewall">Os autores declaram n&#227;o haver conflitos de interesse&#46;</p></span></span>"
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          "palabras" => array:5 [
            0 => "Behavior"
            1 => "Infant"
            2 => "Premature"
            3 => "Neurologic examination"
            4 => "Peri&#47;intraventricular hemorrhage"
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          "titulo" => "Palavras&#8208;chave"
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          "palabras" => array:5 [
            0 => "Comportamento"
            1 => "Neonato"
            2 => "Prematuro"
            3 => "Exame neurol&#243;gico"
            4 => "Hemorragia peri&#47;intraventricular"
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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 evaluate the association between intra&#8208;ventricular hemorrhage and habituation responses to external stimuli in preterm infants at 36&#8211;38 weeks post&#8208;conceptual age&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Cross&#8208;sectional study of infants with gestational age &#60;<span class="elsevierStyleHsp" style=""></span>32 weeks&#46; Intra&#8208;ventricular hemorrhage was identified by cranial ultrasonography and classified according to Papile et al&#46; &#40;1978&#41;&#46; The luminous &#40;flashlight&#41;&#44; sound &#40;rattle&#44; bell&#41;&#44; and tactile stimuli were presented&#44; and the responses were scored according to Lester and Tronik &#40;2004&#41;&#46; Habituation response scores were compared between groups by Student&#39;s <span class="elsevierStyleItalic">t</span>&#8208;test&#46; The association between IVH and habituation scores was evaluated by linear regression adjusted for GA&#44; clinical severity score&#44; post&#8208;conceptual age at habituation assessment&#44; sepsis&#44; and bronchopulmonary dysplasia&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Sixty&#8208;five infants were studied&#44; 20 with intra&#8208;ventricular hemorrhage &#40;16 grades I&#47;II&#59; four grades III&#47;IV&#41; and 45 without intra&#8208;ventricular hemorrhage&#46; Infants with intra&#8208;ventricular hemorrhage had lower gestational age &#40;28&#46;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#46;2 vs&#46; 29&#46;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;7 weeks&#41; and birth weight &#40;990<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>305 vs&#46; 1275<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>360<span class="elsevierStyleHsp" style=""></span>g&#41;&#46; Infants with intra&#8208;ventricular hemorrhage at 36&#8211;38 weeks post&#8208;conceptual age had lower habituation scores to light &#40;4&#46;21<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#46;23 vs&#46; 6&#46;09<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#46;44&#41;&#44; rattle &#40;3&#46;84<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#46;12 vs&#46; 6&#46;18<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#46;27&#41;&#44; and bell &#40;3&#46;58<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;74 vs&#46; 5&#46;20<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#46;47&#41; after controlling for confounders&#46; No differences were found for tactile stimulus&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusion</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Infants with gestational age &#60;<span class="elsevierStyleHsp" style=""></span>32 weeks and intra&#8208;ventricular hemorrhage had poorer habituation responses to external stimuli than those without intra&#8208;ventricular hemorrhage at 36&#8211;38 weeks post&#8208;conceptual age&#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">Avaliar a associa&#231;&#227;o entre hemorragia intraventricular e as respostas de habitua&#231;&#227;o a est&#237;mulos externos em neonatos prematuros com idade p&#243;s&#8208;conceptual de 36&#8208;38 semanas&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">M&#233;todos</span><p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">Estudo transversal com neonatos com idade gestacional &#60; 32 semanas&#46; A hemorragia intraventricular foi identificada por ultrassonografia craniana e classificada de acordo com Papile et al&#46; &#40;1978&#41;&#46; Os est&#237;mulos luminosos &#40;lanterna&#41;&#44; sonoros &#40;chocalho&#44; sino&#41; e t&#225;teis foram apresentados e as respostas foram pontuadas de acordo com Lester &#38; Tronik &#40;2004&#41;&#46; Os escores das respostas de habitua&#231;&#227;o foram comparadas entre os grupos pelo teste t de Student&#46; A associa&#231;&#227;o entre a hemorragia intraventricular e os escores de habitua&#231;&#227;o foi avaliada por regress&#227;o linear ajustada para a idade gestacional&#44; escore de gravidade cl&#237;nica&#44; idade p&#243;s-conceptual na avalia&#231;&#227;o da habitua&#231;&#227;o&#44; sepse e displasia broncopulmonar&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">65 neonatos foram estudados&#44; 20 com hemorragia intraventricular &#40;16 graus I&#47;II&#59;4 graus III&#47;IV&#41; e 45 sem hemorragia intraventricular&#46; Os neonatos com hemorragia intraventricular apresentaram menor idade gestacional &#40;28&#44;2 &#177; 2&#44;2 vs&#46; 29&#44;7 &#177; 1&#44;7 semanas&#41; e peso ao nascer &#40;990 &#177; 305 vs&#46; 1275 &#177; 360 g&#41;&#46; Os neonatos com hemorragia intraventricular na idade p&#243;s-conceptual de 36-38 semanas apresentaram escores de habitua&#231;&#227;o menores a luz &#40;4&#44;21 &#177; 2&#44;23 vs&#46; 6&#44;09 &#177; 2&#44;44&#41;&#44; chocalho &#40;3&#44;84 &#177; 2&#44;12 vs&#46; 6&#44;18 &#177; 2&#44;27&#41; e campainha &#40;3&#44;58 &#177; 1&#44;74 vs&#46; 5&#44;20 &#177; 2&#44;47&#41; ap&#243;s controle para vari&#225;veis de confus&#227;o&#46; Nenhuma diferen&#231;a foi encontrada para os est&#237;mulos t&#225;teis&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclus&#227;o</span><p id="spar0095" class="elsevierStyleSimplePara elsevierViewall">Neonatos com idade gestacional &#60; 32 semanas e hemorragia intraventricular apresentaram respostas de habitua&#231;&#227;o piores a est&#237;mulos externos que os sem hemorragia intraventricular&#44; na idade p&#243;s-conceptual de 36-38 semanas&#46;</p></span>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0035">Como citar este artigo&#58; Bueno GG&#44; Barros MC&#44; Guinsburg R&#46; Preterm infants with peri&#47;intraventricular hemorrhage have poorer habituation responses to external stimuli&#46; J Pediatr &#40;Rio J&#41;&#46; 2019&#59;95&#58;728&#8211;35&#46;</p>"
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          "leyenda" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">cm&#44; cent&#237;metro&#59; IVH&#44; hemorragia peri&#8208;intraventricular&#59; Snappe&#8208;II&#44; Escore para Fisiologia Neonatal Aguda &#8211; Extens&#227;o Perinatal&#44; Vers&#227;o II&#46;</p>"
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Sem IVH&#40;n <span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span> 45&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Com IVH&#40;n <span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span> 20&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">valor de p&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Idade materna &#40;anos&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">27&#44;8&#177;8&#44;6&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">32&#44;3&#177;9&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">0&#44;071&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Acompanhamento pr&#233;&#8208;natal &#8211; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">44 &#40;97&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">20 &#40;100&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&#44;000&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Hipertens&#227;o durante a gravidez &#8211; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">7 &#40;15&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&#44;000&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Corioamnionite &#8211; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Corticoterapia antenatal &#8211; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">Parto ces&#225;reo &#8211; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">&#205;ndice de Apgar no 1&#176; minuto&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#205;ndice de Apgar no 5&#176; minuto&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Idade gestacional &#40;semanas&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Peso ao nascer &#40;gramas&#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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Per&#237;metro cef&#225;lico &#40;cm&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;035&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Pequeno para a idade gestacional &#8211; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">9 &#40;20&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Pontua&#231;&#227;o Snappe&#8208;II&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;028&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\tvoid\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Com IVH &#40;n <span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span> 45&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Sem IVH &#40;n <span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span> 20&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">valor de p&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Taquipneia transit&#243;ria &#8211; n &#40;&#37;&#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="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">S&#237;ndrome do desconforto respirat&#243;rio &#8211; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hipertens&#227;o pulmonar &#8211; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 &#40;8&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;15&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;667&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Persist&#234;ncia do canal arterial &#8211; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14 &#40;31&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;40&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;574&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Displasia broncopulmonar &#8211; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16 &#40;35&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13 &#40;65&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;034&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Apneia &#8211; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">23 &#40;51&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;40&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;435&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Sepse cl&#237;nica &#8211; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;17&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;40&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;068&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Meningite &#8211; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#40;4&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;5&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Enterocolite necrosante &#8211; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;2&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0 &#40;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Retinopatia da prematuridade &#8211; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 &#40;8&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;15&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;667&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Ventila&#231;&#227;o mec&#226;nica &#8211; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18 &#40;40&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16 &#40;80&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;003&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Dias de ventila&#231;&#227;o mec&#226;nica<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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#44;0 &#40;2&#44;0 &#8211; 10&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&#44;5 &#40;5&#44;0 &#8211; 44&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;006&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Surfactante ex&#243;geno &#8211; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16 &#40;35&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13 &#40;65&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;034&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Ibuprofeno &#8211; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 &#40;8&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&#44; &#40;50&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Esteroides p&#243;s&#8208;natal &#8211; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;4&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 &#40;30&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;008&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Analg&#233;sicos ou sedativos &#8211; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11 &#40;55&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 &#40;11&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Emiss&#245;es otoac&#250;sticas ausentes bilateralmente &#8211; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;5&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;4&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;588&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Fun&#231;&#227;o auditiva anormal do tronco encef&#225;lico &#8211; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;15&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 &#40;11&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;974&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Idade na alta hospitalar &#40;dias&#41;<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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">51&#44;1&#177;22&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">73&#44;9&#177;35&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;014&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Idade p&#243;s&#8208;conceitual na alta &#40;semanas&#41;<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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">37&#44;0&#177;2&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">38&#44;7&#177;3&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;037&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Peso na alta hospitalar &#40;gramas&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2405&#177;344&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2565&#177;622&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;291&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Per&#237;metro cef&#225;lico na alta &#40;cm&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">32&#44;4&#177;1&#44;6&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">32&#44;4&#177;1&#44;8&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;926&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Sem IVH&#40;n <span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span> 45&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Com IVH&#40;n <span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span> 20&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">valor de p&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Idade no exame &#40;dias&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">47&#44;7&#177;21&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">68&#44;0&#177;28&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;002&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Idade p&#243;s&#8208;conceptual no exame &#40;semanas&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">36&#44;5&#177;2&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">37&#44;9&#177;2&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;019&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Estado inicial de sono e vig&#237;lia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;11&#177;0&#44;32&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;25&#177;0&#44;44&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;217&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Estado intermedi&#225;rio de sono e vig&#237;lia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;96&#177;0&#44;56&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;90&#177;0&#44;64&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;726&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Estado final de sono e vig&#237;lia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;33&#177;0&#44;83&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;40&#177;0&#44;99&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Pontua&#231;&#227;o de habitua&#231;&#227;o &#224; luz&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#44;09&#177;2&#44;44&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#44;21&#177;2&#44;23<a class="elsevierStyleCrossRef" href="#tblfn0025"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;005&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Habitua&#231;&#227;o ao est&#237;mulo luminoso &#8211; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">31 &#40;68&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 &#40;26&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;002&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Pontua&#231;&#227;o de habitua&#231;&#227;o ao chocalho&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#44;18&#177;2&#44;27<a class="elsevierStyleCrossRef" href="#tblfn0030"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#44;84&#177;2&#44;12<a class="elsevierStyleCrossRef" href="#tblfn0025"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;004&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Habitua&#231;&#227;o ao chocalho &#8211; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">31 &#40;70&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;15&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Pontua&#231;&#227;o de habitua&#231;&#227;o &#224; campainha&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#44;20&#177;2&#44;47<a class="elsevierStyleCrossRef" href="#tblfn0030"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#44;58&#177;1&#44;74<a class="elsevierStyleCrossRef" href="#tblfn0025"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Habitua&#231;&#227;o &#224; campainha &#8211; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">24 &#40;54&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;15&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;005&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Pontua&#231;&#227;o de habitua&#231;&#227;o ao est&#237;mulo t&#225;til&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#44;98&#177;2&#44;27<a class="elsevierStyleCrossRef" href="#tblfn0030"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#44;30&#177;2&#44;34&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;277&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Pontua&#231;&#227;o de habitua&#231;&#227;o &#224; luz&#44; ao chocalho e &#224; campainha&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#44;80&#177;1&#44;85&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">3&#44;88&#177;1&#44;79&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Habitua&#231;&#227;o &#224; luz&#44; ao chocalho e &#224; campainha &#8211; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">31 &#40;68&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 &#40;21&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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              "nota" => "<p class="elsevierStyleNotepara" id="npar0030">Dados dispon&#237;veis para 44 pacientes&#46;</p>"
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        "descripcion" => array:1 [
          "pt" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Avalia&#231;&#227;o das respostas de habitua&#231;&#227;o dos neonatos estudados&#44; de acordo com a presen&#231;a de IVH</p>"
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          "leyenda" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">IVH&#44; hemorragia peri&#8208;intraventricular&#46;</p>"
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Coeficiente B &#40;IC de 95&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">valor de p&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Habitua&#231;&#227;o &#224; luz &#8211; p <span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span> 0&#44;012&#59; r<span class="elsevierStyleSup">2</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span> 0&#44;116&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">IVH&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#8722;1&#44;465 &#40;&#8722;2&#44;893&#59; &#8722;0&#44;037&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;044&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Sepse&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#8722;1&#44;256 &#40;&#8722;2&#44;734&#59; 0&#44;222&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;094&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Habitua&#231;&#227;o ao chocalho &#8211; p <span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span> 0&#44;001&#59; r<span class="elsevierStyleSup">2</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span> 0&#44;176&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">IVH&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;2&#44;291 &#40;&#8722;3&#44;584&#59; &#8722;1&#44;017&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Habitua&#231;&#227;o &#224; campainha &#8211; p <span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span> 0&#44;011&#59; r<span class="elsevierStyleSup">2</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span> 0&#44;095&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">IVH&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;1&#44;697 &#40;&#8722;2&#44;996&#59; &#8722;0&#44;398&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Habitua&#231;&#227;o &#224; luz&#44; ao chocalho e &#224; campainha &#8211; p <span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span> 0&#44;001&#59; r<span class="elsevierStyleSup">2</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span> 0&#44;167&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">IVH&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;1&#44;891 &#40;&#8722;2&#44;965&#59; &#8722;0&#44;917&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Habitua&#231;&#227;o &#224; luz&#44; ao chocalho&#44; &#224; campainha e ao est&#237;mulo t&#225;til &#8211; p <span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span> 0&#44;001&#59; r<span class="elsevierStyleSup">2</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span> 0&#44;159&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">IVH&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;1&#44;600 &#40;&#8722;2&#44;526&#59; &#8722;0&#44;673&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
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                0 => "xTab2155616.png"
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        ]
        "descripcion" => array:1 [
          "pt" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Associa&#231;&#227;o entre as pontua&#231;&#245;es de IVH e habitua&#231;&#227;o por meio da an&#225;lise de regress&#227;o linear m&#250;ltipla</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "Refer&#234;ncias"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0015"
          "bibliografiaReferencia" => array:29 [
            0 => array:3 [
              "identificador" => "bib0150"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Trends in care practices&#44; morbidity&#44; and mortality of extremely preterm neonates&#44; 1993&#8211;2012"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "B&#46;J&#46; Stoll"
                            1 => "N&#46;I&#46; Hansen"
                            2 => "E&#46;F&#46; Bell"
                            3 => "M&#46;C&#46; Walsh"
                            4 => "W&#46;A&#46; Carlo"
                            5 => "S&#46; Shankaran"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1001/jama.2015.10244"
                      "Revista" => array:6 [
                        "tituloSerie" => "JAMA"
                        "fecha" => "2015"
                        "volumen" => "314"
                        "paginaInicial" => "1039"
                        "paginaFinal" => "1051"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26348753"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
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              "identificador" => "bib0155"
              "etiqueta" => "2"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Incidence and evolution of subependymal and intraventricular hemorrhage&#58; a study of infants with birth weights less than 1&#44;500 g"
                      "autores" => array:1 [
                        0 => array:2 [
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