Factores asociados con inadecuados depósitos de hierro en mujeres en primer trimestre de gestación
Introducción: niveles bajos de ferritina sérica en la gestación se asocian con inadecuados depósitos de hierro, lo cual puede producir anemia, y aumentar el riesgo de mortalidad materna, parto prematuro y deficiencias a largo plazo en el desarrollo cognitivo del neonato. Objetivo: determinar la rela...
- Autores:
-
Arango Alzate, Catalina María
Molina Castaño, Carlos Federico
Mejía Merino, Cristina
- Tipo de recurso:
- Article of investigation
- Fecha de publicación:
- 2021
- Institución:
- Tecnológico de Antioquia
- Repositorio:
- Repositorio Tdea
- Idioma:
- spa
- OAI Identifier:
- oai:dspace.tdea.edu.co:tdea/2656
- Acceso en línea:
- https://dspace.tdea.edu.co/handle/tdea/2656
- Palabra clave:
- enfermedades de la sangre
anemia
Transtornos sanguíneos
Deficiencia de hierro
Iron Deficiencies
Deficiências de Ferro
Ferritina
Embarazo
Pregnancy
Gravidez
Gestación
Nutrición
Nutrición materna
Maternal Nutrition
Nutrição Materna
- Rights
- openAccess
- License
- https://creativecommons.org/licenses/by-nc/4.0/
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dc.title.none.fl_str_mv |
Factores asociados con inadecuados depósitos de hierro en mujeres en primer trimestre de gestación |
dc.title.translated.none.fl_str_mv |
Factors associated with inadequate iron stores in women in the first trimester of pregnancy |
title |
Factores asociados con inadecuados depósitos de hierro en mujeres en primer trimestre de gestación |
spellingShingle |
Factores asociados con inadecuados depósitos de hierro en mujeres en primer trimestre de gestación enfermedades de la sangre anemia Transtornos sanguíneos Deficiencia de hierro Iron Deficiencies Deficiências de Ferro Ferritina Embarazo Pregnancy Gravidez Gestación Nutrición Nutrición materna Maternal Nutrition Nutrição Materna |
title_short |
Factores asociados con inadecuados depósitos de hierro en mujeres en primer trimestre de gestación |
title_full |
Factores asociados con inadecuados depósitos de hierro en mujeres en primer trimestre de gestación |
title_fullStr |
Factores asociados con inadecuados depósitos de hierro en mujeres en primer trimestre de gestación |
title_full_unstemmed |
Factores asociados con inadecuados depósitos de hierro en mujeres en primer trimestre de gestación |
title_sort |
Factores asociados con inadecuados depósitos de hierro en mujeres en primer trimestre de gestación |
dc.creator.fl_str_mv |
Arango Alzate, Catalina María Molina Castaño, Carlos Federico Mejía Merino, Cristina |
dc.contributor.author.none.fl_str_mv |
Arango Alzate, Catalina María Molina Castaño, Carlos Federico Mejía Merino, Cristina |
dc.subject.other.none.fl_str_mv |
enfermedades de la sangre |
topic |
enfermedades de la sangre anemia Transtornos sanguíneos Deficiencia de hierro Iron Deficiencies Deficiências de Ferro Ferritina Embarazo Pregnancy Gravidez Gestación Nutrición Nutrición materna Maternal Nutrition Nutrição Materna |
dc.subject.agrovoc.none.fl_str_mv |
anemia Transtornos sanguíneos |
dc.subject.decs.none.fl_str_mv |
Deficiencia de hierro Iron Deficiencies Deficiências de Ferro Ferritina Embarazo Pregnancy Gravidez Gestación Nutrición Nutrición materna Maternal Nutrition Nutrição Materna |
description |
Introducción: niveles bajos de ferritina sérica en la gestación se asocian con inadecuados depósitos de hierro, lo cual puede producir anemia, y aumentar el riesgo de mortalidad materna, parto prematuro y deficiencias a largo plazo en el desarrollo cognitivo del neonato. Objetivo: determinar la relación entre factores demográficos, económicos, familiares y de seguridad alimentaria con los inadecuados depósitos de hierro en mujeres en primer trimestre de gestación. Métodos: estudio descriptivo transversal, con 664 mujeres en primer trimestre de gestación. Depósitos de hierro inadecuados se definieron como una concentración de ferritina sérica <30 μg/L. Se estimó la prueba chi cuadrado, se calcularon odds ratio crudas y ajustadas mediante regresión logística binaria. Resultados: La proporción de mujeres con depósitos de hierro inadecuados fue de 32%, promedio geométrico de ferritina de 39,2 μg/L (rango 38,4 - 40,0 μg/L) Las gestantes que no deseaban el embarazo, tuvieron 1,1 veces más posibilidad de tener inadecuados depósitos de hierro comparado con las que si lo deseaban (OR= 2,10 IC95% 1,18-3,74). La inseguridad alimentaria incrementó en un 47% la probabilidad de tener inadecuados depósitos de hierro (OR= 1,47 IC95% 1,02-2,13). El apoyo familiar redujo en un 61% la probabilidad de inadecuados depósitos de hierro (OR= 0,39 IC95% 0,19-0,78). Conclusión: Una de cada tres mujeres presentó inadecuados niveles séricos de ferritina, lo cual se asoció principalmente con factores socioeconómicos y familiares, esto sugiere la necesidad de considerar otros aspectos no clínicos en las intervenciones que se hacen antes del embarazo para mejorar las reservas de hierro |
publishDate |
2021 |
dc.date.issued.none.fl_str_mv |
2021 |
dc.date.accessioned.none.fl_str_mv |
2023-03-22T05:11:02Z |
dc.date.available.none.fl_str_mv |
2023-03-22T05:11:02Z |
dc.type.spa.fl_str_mv |
Artículo de revista |
dc.type.coarversion.fl_str_mv |
http://purl.org/coar/version/c_970fb48d4fbd8a85 |
dc.type.coar.spa.fl_str_mv |
http://purl.org/coar/resource_type/c_2df8fbb1 |
dc.type.content.spa.fl_str_mv |
Text |
dc.type.driver.spa.fl_str_mv |
info:eu-repo/semantics/article |
format |
http://purl.org/coar/resource_type/c_2df8fbb1 |
dc.identifier.uri.none.fl_str_mv |
https://dspace.tdea.edu.co/handle/tdea/2656 |
dc.identifier.eissn.spa.fl_str_mv |
0717-7518 |
url |
https://dspace.tdea.edu.co/handle/tdea/2656 |
identifier_str_mv |
0717-7518 |
dc.language.iso.spa.fl_str_mv |
spa |
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595 |
dc.relation.citationvolume.spa.fl_str_mv |
48 |
dc.relation.ispartofjournal.spa.fl_str_mv |
Revista chilena de nutrición |
dc.relation.issourceof.none.fl_str_mv |
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85114184247&doi=10.4067%2fS0717-75182021000400595&partnerID=40 |
dc.relation.references.spa.fl_str_mv |
National Committee of Hematology, Oncology and Transfusion Medicine and National Committee of Nutrition. Iron deficiency and iron deficiency anemia. Guideline for prevention, diagnosis and treatment. Arch Argent Pediatr. 2017; 115: 68-82. Ramírez R, González K, Correa JE, Martínez J, Meneses JF, Rincón D. Ferritin levels in pregnant Colombian women. Nutr Hosp. 2015; 31: 793-797 FAO, FIDA, OMS, PMA, UNICEF. The State of Food Security and Nutrition in the World 2020. Transforming food systems to promote affordable and healthy diets. www.fao.org/ publications/es Development Initiative Poverty Research Ltd. World Nutrition Report 2020. https://globalnutritionreport.org/reports/2020- global-nutrition-report/ Ministry of health and social protection, Colombian Institute of Family Welfare - ICBF. National Survey of the Nutritional Situation - ENSIN 2015. 2020. https://www.minsalud.gov. co/sites/rid/Lists/BibliotecaDigital/RIDE/VS/ED/GCFI/libroensin-2015.pdf World Health Organization. Serum ferritin concentrations for the assessment of iron status and iron deficiency in populations. 2011. https://www.who.int/vmnis/indicators/serum_ferritin. pdf World Health Organization. Serum ferritin concentrations for the assessment of iron status in individuals and populations: technical brief. 2020. https://apps.who.int/iris/handle/10665/337666 Milman N. Physiopathology and impact of iron deficiency and anemia in the pregnant women and newborn/infant. Rev Peru Ginecol Obstet. 2012; 58: 293-312. Auerbach M, Abernathy J, Juul S, Short V, Derman R. Prevalence of iron deficiency in first trimester, nonanemic pregnant women. J Matern Fetal Neonatal Med. 2019; 34: 1002-1004. Auerbach M. Commentary: Iron deficiency of pregnancy-a new approach involving intravenous iron. Reprod Health. 2018; 15: 109-115. Breymann C, Auerbach M. Iron deficiency in gynecology and obstetrics: Clinical implications and management. Hematology. 2017; 1: 152-159. Iqbal S, Ekmekcioglu C. Maternal and neonatal outcomes related to iron supplementation or iron status: A summary of meta-analyses. J Matern Fetal Neonatal Med. 2019; 32: 1528-1540. Kemppinen L, Mattila M, Ekholm E, Pallasmaa N, Törmä A, Varakas L, et al. Gestational iron deficiency anemia is associated with preterm birth, fetal growth restriction, and postpartum infections. J Perinat Med. 2021; 49: 431-438. Ndukwu GU, Dienye PO. Prevalence and socio-demographic factors associated with anaemia in pregnancy in a primary health centre in Rivers State, Nigeria. Afr J Prim Health Care Fam Med. 2012; 4: 1-7. Kangalgil M, Sahinler A, Kirkbir LIB, Özçelik AÖ. Associations of maternal characteristics and dietary factors with anemia and iron-deficiency in pregnancy. J Gynecol Obstet Hum Reprod. 2021; 50: 102-137. Bencaiova G, Burkhardt T, Breymann C. Anemia - prevalence and risk factors in pregnancy. Eur J Intern Med. 2012; 23: 529-533. Demétrio F, Teles CA, Santos DB. Food insecurity, prenatal care and other anemia determinants in pregnant women from the NISAMI cohort, Brazil: Hierarchical model concept. Rev Bras Ginecol Obstet. 2017; 39: 384-396. Fischer NC, Shamah T, Mundo V, Méndez I, Pérez R. Household food insecurity is associated with anemia in adult Mexican women of reproductive age. J Nutr. 2014; 144: 2066-2072. Scholing JM, Olthof MR, Jonker FA, Vrijkotte TG. Association between pre-pregnancy weight status and maternal micronutrient status in early pregnancy. Public Health Nutr. 2018; 21: 2046-2055 Casanova BF, Sammel MD, Macones GA. Development of a clinical prediction rule for iron deficiency anemia in pregnancy. Am J Obstet Gynecol. 2005; 193: 460-466 VandenBroek. Iron status in pregnant women: which measurements are valid? Br J Haematol. 1998; 103: 817-824 World Health Organization. Hemoglobin levels to diagnose anemia and assess its severity. 2011. https://www.who.int/ vmnis/indicators/haemoglobin_es.pdf World Health Organization. C-reactive protein concentrations as a marker of inflammation or infection for interpreting biomarkers of micronutrient status. 2014. https://www. who.int/nutrition/publications/micronutrients/indicators_creactive_protein/en/ DNP National Planning Department of Colombia. CONPES Social 117 of 2008: Updating of the criteria for the determination, identification and selection of beneficiaries of social programs. https://www.sisben.gov.co/Paginas/ documentos-conpes.aspx FAO, ELCSA Scientific Committee. Latin American and Caribbean food safety scale (ELCSA): use and application manual. Roma, Italia. 2012; 17 . Atalah E, Castillo C, Castro R, Aldea A. Proposal of a new standard for the nutritional assessment of pregnant women. Rev Méd Chile. 1997; 125: 1429-1436 Moradi S, Arghavani H, Issah A, Mohammadi H, Mirzaei K. Food insecurity and anaemia risk: A systematic review and meta-analysis. Public Health Nutr. 2018; 21: 3067-3079 Loy SL, Lim LM, Chan SY, Tan PT, Chee YL, Quah PL, et al. Iron status and risk factors of iron deficiency among pregnant women in Singapore: A cross-sectional study. BMC Public Health. 2019; 19: 397-407 Dos Santos MTL, De Mendonça KM, Pinhneiro IMP, De Sousa EFDS, Szarfarc SC, et al. Anemia and iron deficiency in primigent parturients in a municipality of Brazilian west Amazon. Medicine (Baltimore). 2020; 99: 1-7. Méndez RO, Pacheco B, Noriega H, Quihui L, Morales G, Valencia J ME. Prevalence of iron deficiency and iron deficiency anemia in pregnant adolescents from Northwest Mexico, 2007-2008. Arch Latinoam Nutr. 2009; 59: 147-151. Khambalia AZ, Collins CE, Roberts CL, Morris JM, Powell KL, Tasevski V, et al. Iron deficiency in early pregnancy using serum ferritin and soluble transferrin receptor concentrations are associated with pregnancy and birth outcomes. Eur J Clin Nutr. 2016; 70: 358-363. Gomes A, Vargas S, Clode N, M Graça L. Prevalence and risk factors for iron deficiency anemia and iron depletion during pregnancy: A prospective study. Acta Med Port. 2016; 29: 514-518. Rasmussen K. Is there a causal relationship between iron deficiency or iron-deficiency anemia and weight at birth, length of gestation and perinatal mortality? J Nutr. 2001; 13: 590S-603S. Jones AD, Zhao G, Jiang YP, Zhou M, Xu G, Kaciroti N, et al. Maternal obesity during pregnancy is negatively associated with maternal and neonatal iron status. Eur J Clin Nutr. 2016; 70: 918-924. Garcia L, Campoy C, Hayes H, Florido J, Rusanova I, Miranda MT, et al. The impact of maternal obesity on iron status, placental transferrin receptor expression and hepcidin expression in human pregnancy. Int J Obes 2005. 2015; 39: 571-578 McCarthy EK, Kenny LC, Hourihane JOB, Irvine AD, Murray DM, Kiely ME. Impact of maternal, antenatal and birth-associated factors on iron stores at birth: Data from a prospective maternal-infant birth cohort. Eur J Clin Nutr. 2017; 71: 782-787 Parra BE, Restrepo SL, Manjarrés LM, Mancilla LP. Biochemical indicators of maternal iron in the third trimester of pregnancy and their relation with maternal anthropometry and neonatal weight. IATREIA. 2009; 22: 16-26. Cepeda AC, Melse A, Zimmermann MB, Herter I. In overweight and obese women, dietary iron absorption is reduced and the enhancement of iron absorption by ascorbic acid is one-half that in normal-weight women. Am J Clin Nutr. 2015; 102: 1389-1397. Mujica MF, Brito A, Romaña DL, Pizarro F, Olivares M. Body mass index, iron absorption and iron status in childbearing age women. J Trace Elem Med Biol. 2015; 30: 215-219. Flynn AC, Begum S, White SL, Dalrymple K, Gill C, Alwan NA, et al. Relationships between maternal obesity and maternal and neonatal iron status. Nutrients. 2018; 10: 1000-1010. Ahmed F, Al-Sumaie MA. Risk factors associated with anemia and iron deficiency among Kuwaiti pregnant women. Int J Food Sci Nutr. 2011; 62: 585-592. Gómez I, Rosales S, Agreda L, Castillo A, Alarcón E, Gutiérrez C. Hemoglobine level and prevalence of anemia in pregnant women by socio-demographicand antenatal characteristics. 2014; 18: 1-6. Grum T, Brhane E, Hintsa S, Kahsay G. Magnitude and factors associated with anemia among pregnant women attending antenatal care in public health centers in central zone of Tigray region, northern Ethiopia: a cross sectional study. BMC Pregnancy Childbirth. 2018; 18: 433-440 Barón MA, Solano L, Peña E, Sánche A, Del Rea S. State of iron stores in early pregnancy. Investig Clínica. 2005; 46: 121-130. Martí A, Peña G, Comunian G, Muñoz S. Prevalence of anemia during pregnancy: Results of Valencia (Venezuela) anemia during pregnancy study. Arch Latinoam Nutr. 2002; 52: 5-11. Park CY, Eicher HA. Iron deficiency is associated with food insecurity in pregnant females in the United States: National Health and Nutrition Examination Survey 1999-2010. J Acad Nutr Diet. 2014; 114: 1967-1973. Peña JP, De‐Regil LM, Garcia MN, Dowswell T. Daily oral iron supplementation during pregnancy. Cochrane Database Syst Rev. 2015; 22. World Health Organization. Guideline: Daily iron and folic acid supplementation in pregnant women. 2012. https://apps.who. int/iris/bitstream/handle/10665/77770/9789241501996_eng. pdf Ministry of Health and Social Protection of Colombia. Clinical Practice Guidelines for the prevention, early detection and treatment of complications of pregnancy, childbirth or the puerperium. 2013. https://www.minsalud.gov.co/sites/rid/Lists/BibliotecaDigital/RIDE/INEC/IETS/G.Corta.Embarazo.y.parto. Prof.Salud.2013%20(1).pdf Escudero LS, Parra BE, Herrera J, Restrepo SL, Zapata N. Nutritional status of iron in pregnant teenagers: Medellín, Colombia. Rev Fac Nac Salud Pública. 2014; 32: 71-79. Ministry of Health and Social Protection of Colombia. National strategy for the prevention and control of micronutrient deficiencies in Colombia 2014-2021. 2015. https://www. minsalud.gov.co/sites/rid/Lists/BibliotecaDigital/RIDE/VS/ PP/SNA/Estrategia-nacional-prevencion-control-deficienciamicronutrientes.pdf Ministry of health and social protection. Analysis of the regulatory impact on prevention and control of micronutrient deficiencies in Colombia. https://www.minsalud.gov. co/Normativa/Documents/AIN-Deficiencia%20de%20 micronutrientes%20.pdf |
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Santiago de Chile |
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Arango Alzate, Catalina María4c74c649-cc88-49b4-ac43-b5d73be2a12aMolina Castaño, Carlos Federico0bc3477d-f51c-460a-8587-5015dbb715ecMejía Merino, Cristinad40d4557-9203-44c4-8e94-869edc3ecfb22023-03-22T05:11:02Z2023-03-22T05:11:02Z2021https://dspace.tdea.edu.co/handle/tdea/26560717-7518Introducción: niveles bajos de ferritina sérica en la gestación se asocian con inadecuados depósitos de hierro, lo cual puede producir anemia, y aumentar el riesgo de mortalidad materna, parto prematuro y deficiencias a largo plazo en el desarrollo cognitivo del neonato. Objetivo: determinar la relación entre factores demográficos, económicos, familiares y de seguridad alimentaria con los inadecuados depósitos de hierro en mujeres en primer trimestre de gestación. Métodos: estudio descriptivo transversal, con 664 mujeres en primer trimestre de gestación. Depósitos de hierro inadecuados se definieron como una concentración de ferritina sérica <30 μg/L. Se estimó la prueba chi cuadrado, se calcularon odds ratio crudas y ajustadas mediante regresión logística binaria. Resultados: La proporción de mujeres con depósitos de hierro inadecuados fue de 32%, promedio geométrico de ferritina de 39,2 μg/L (rango 38,4 - 40,0 μg/L) Las gestantes que no deseaban el embarazo, tuvieron 1,1 veces más posibilidad de tener inadecuados depósitos de hierro comparado con las que si lo deseaban (OR= 2,10 IC95% 1,18-3,74). La inseguridad alimentaria incrementó en un 47% la probabilidad de tener inadecuados depósitos de hierro (OR= 1,47 IC95% 1,02-2,13). El apoyo familiar redujo en un 61% la probabilidad de inadecuados depósitos de hierro (OR= 0,39 IC95% 0,19-0,78). Conclusión: Una de cada tres mujeres presentó inadecuados niveles séricos de ferritina, lo cual se asoció principalmente con factores socioeconómicos y familiares, esto sugiere la necesidad de considerar otros aspectos no clínicos en las intervenciones que se hacen antes del embarazo para mejorar las reservas de hierroIntroduction: Low levels of serum ferritin in pregnancy are associated with inadequate iron stores, which can cause anemia and increase the risk of maternal mortality, premature delivery, and long-term deficiencies in the cognitive development of the newborn. Objective: To determine the relationship between demographic, economic, family and food security factors with inadequate iron stores in women in the first trimester of pregnancy. Methods: Descriptive cross-sectional study with 664 women in the first trimester of pregnancy. Inadequate iron stores were defined as a serum ferritin concentration <30 μg / L. The chi-square test was estimated, crude and adjusted odds ratios were calculated using binary logistic regression. Results: The proportion of women with inadequate iron stores was 32%, geometric average of ferritin 39.2 μg/L (rank 38.4 - 40.0 μg/L). Pregnant women who did not want a pregnancy were 1.1 times more likely to have inadequate iron stores compared to those who did (OR= 2.10; 95% CI 1.18-3.74). Food insecurity increased the probability of having inadequate iron stores by 47% (OR= 1.47; 95% CI: 1.02-2.13). Family support reduced the probability of inadequate iron stores by 61% (OR= 0.39; 95% CI 0.19-0.78). Conclusion: One in three women presented inadequate levels of serum ferritin, which was mainly associated with socioeconomic and family factors, this suggests the need to consider other non-clinical aspects in the interventions carried out before pregnancy to improve iron stores14 páginasapplication/pdfspaSociedad Chilena de Nutrición Bromatología y ToxicologíaSantiago de Chilehttps://creativecommons.org/licenses/by-nc/4.0/info:eu-repo/semantics/openAccesshttp://purl.org/coar/access_right/c_abf2https://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0717-75182021000400595&lng=en&nrm=iso&tlng=enenfermedades de la sangreanemiaTranstornos sanguíneosDeficiencia de hierroIron DeficienciesDeficiências de FerroFerritinaEmbarazoPregnancyGravidezGestaciónNutriciónNutrición maternaMaternal NutritionNutrição MaternaFactores asociados con inadecuados depósitos de hierro en mujeres en primer trimestre de gestaciónFactors associated with inadequate iron stores in women in the first trimester of pregnancyArtículo de revistahttp://purl.org/coar/resource_type/c_2df8fbb1Textinfo:eu-repo/semantics/articlehttp://purl.org/coar/version/c_970fb48d4fbd8a85Medellín, Colombia608459548Revista chilena de nutriciónhttps://www.scopus.com/inward/record.uri?eid=2-s2.0-85114184247&doi=10.4067%2fS0717-75182021000400595&partnerID=40National Committee of Hematology, Oncology and Transfusion Medicine and National Committee of Nutrition. Iron deficiency and iron deficiency anemia. Guideline for prevention, diagnosis and treatment. Arch Argent Pediatr. 2017; 115: 68-82.Ramírez R, González K, Correa JE, Martínez J, Meneses JF, Rincón D. Ferritin levels in pregnant Colombian women. Nutr Hosp. 2015; 31: 793-797FAO, FIDA, OMS, PMA, UNICEF. The State of Food Security and Nutrition in the World 2020. Transforming food systems to promote affordable and healthy diets. www.fao.org/ publications/esDevelopment Initiative Poverty Research Ltd. World Nutrition Report 2020. https://globalnutritionreport.org/reports/2020- global-nutrition-report/Ministry of health and social protection, Colombian Institute of Family Welfare - ICBF. National Survey of the Nutritional Situation - ENSIN 2015. 2020. https://www.minsalud.gov. co/sites/rid/Lists/BibliotecaDigital/RIDE/VS/ED/GCFI/libroensin-2015.pdfWorld Health Organization. Serum ferritin concentrations for the assessment of iron status and iron deficiency in populations. 2011. https://www.who.int/vmnis/indicators/serum_ferritin. pdfWorld Health Organization. Serum ferritin concentrations for the assessment of iron status in individuals and populations: technical brief. 2020. https://apps.who.int/iris/handle/10665/337666Milman N. Physiopathology and impact of iron deficiency and anemia in the pregnant women and newborn/infant. Rev Peru Ginecol Obstet. 2012; 58: 293-312.Auerbach M, Abernathy J, Juul S, Short V, Derman R. Prevalence of iron deficiency in first trimester, nonanemic pregnant women. J Matern Fetal Neonatal Med. 2019; 34: 1002-1004.Auerbach M. Commentary: Iron deficiency of pregnancy-a new approach involving intravenous iron. Reprod Health. 2018; 15: 109-115.Breymann C, Auerbach M. Iron deficiency in gynecology and obstetrics: Clinical implications and management. Hematology. 2017; 1: 152-159.Iqbal S, Ekmekcioglu C. 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National strategy for the prevention and control of micronutrient deficiencies in Colombia 2014-2021. 2015. https://www. minsalud.gov.co/sites/rid/Lists/BibliotecaDigital/RIDE/VS/ PP/SNA/Estrategia-nacional-prevencion-control-deficienciamicronutrientes.pdfMinistry of health and social protection. 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 incorporada en las Obras Colectivas.

b.	Distribuir copias o fonogramas de las Obras, exhibirlas públicamente, ejecutarlas públicamente y/o ponerlas a disposición pública, incluyéndolas como incorporadas en Obras Colectivas, según corresponda.

c.	Distribuir copias de las Obras Derivadas que se generen, exhibirlas públicamente, ejecutarlas públicamente y/o ponerlas a disposición pública.
Los derechos mencionados anteriormente pueden ser ejercidos en todos los medios y formatos, actualmente conocidos o que se inventen en el futuro. Los derechos antes mencionados incluyen el derecho a realizar dichas modificaciones en la medida que sean técnicamente necesarias para ejercer los derechos en otro medio o formatos, pero de otra manera usted no está autorizado para realizar obras derivadas. Todos los derechos no otorgados expresamente por el Licenciante quedan por este medio reservados, incluyendo pero sin limitarse a aquellos que se mencionan en las secciones 4(d) y 4(e).

4. Restricciones.
La licencia otorgada en la anterior Sección 3 está expresamente sujeta y limitada por las siguientes restricciones:

a.	Usted puede distribuir, exhibir públicamente, ejecutar públicamente, o poner a disposición pública la Obra sólo bajo las condiciones de esta Licencia, y Usted debe incluir una copia de esta licencia o del Identificador Universal de Recursos de la misma con cada copia de la Obra que distribuya, exhiba públicamente, ejecute públicamente o ponga a disposición pública. No es posible ofrecer o imponer ninguna condición sobre la Obra que altere o limite las condiciones de esta Licencia o el ejercicio de los derechos de los destinatarios otorgados en este documento. No es posible sublicenciar la Obra. Usted debe mantener intactos todos los avisos que hagan referencia a esta Licencia y a la cláusula de limitación de garantías. Usted no puede distribuir, exhibir públicamente, ejecutar públicamente, o poner a disposición pública la Obra con alguna medida tecnológica que controle el acceso o la utilización de ella de una forma que sea inconsistente con las condiciones de esta Licencia. Lo anterior se aplica a la Obra incorporada a una Obra Colectiva, pero esto no exige que la Obra Colectiva aparte de la obra misma quede sujeta a las condiciones de esta Licencia. Si Usted crea una Obra Colectiva, previo aviso de cualquier Licenciante debe, en la medida de lo posible, eliminar de la Obra Colectiva cualquier referencia a dicho Licenciante o al Autor Original, según lo solicitado por el Licenciante y conforme lo exige la cláusula 4(c).

b.	Usted no puede ejercer ninguno de los derechos que le han sido otorgados en la Sección 3 precedente de modo que estén principalmente destinados o directamente dirigidos a conseguir un provecho comercial o una compensación monetaria privada. El intercambio de la Obra por otras obras protegidas por derechos de autor, ya sea a través de un sistema para compartir archivos digitales (digital file-sharing) o de cualquier otra manera no será considerado como estar destinado principalmente o dirigido directamente a conseguir un provecho comercial o una compensación monetaria privada, siempre que no se realice un pago mediante una compensación monetaria en relación con el intercambio de obras protegidas por el derecho de autor.

c.	Si usted distribuye, exhibe públicamente, ejecuta públicamente o ejecuta públicamente en forma digital la Obra o cualquier Obra Derivada u Obra Colectiva, Usted debe mantener intacta toda la información de derecho de autor de la Obra y proporcionar, de forma razonable según el medio o manera que Usted esté utilizando: (i) el nombre del Autor Original si está provisto (o seudónimo, si fuere aplicable), y/o (ii) el nombre de la parte o las partes que el Autor Original y/o el Licenciante hubieren designado para la atribución (v.g., un instituto patrocinador, editorial, publicación) en la información de los derechos de autor del Licenciante, términos de servicios o de otras formas razonables; el título de la Obra si está provisto; en la medida de lo razonablemente factible y, si está provisto, el Identificador Uniforme de Recursos (Uniform Resource Identifier) que el Licenciante especifica para ser asociado con la Obra, salvo que tal URI no se refiera a la nota sobre los derechos de autor o a la información sobre el licenciamiento de la Obra; y en el caso de una Obra Derivada, atribuir el crédito identificando el uso de la Obra en la Obra Derivada (v.g., "Traducción Francesa de la Obra del Autor Original," o "Guión Cinematográfico basado en la Obra original del Autor Original"). Tal crédito puede ser implementado de cualquier forma razonable; en el caso, sin embargo, de Obras Derivadas u Obras Colectivas, tal crédito aparecerá, como mínimo, donde aparece el crédito de cualquier otro autor comparable y de una manera, al menos, tan destacada como el crédito de otro autor comparable.

d.	Para evitar toda confusión, el Licenciante aclara que, cuando la obra es una composición musical:

i.	Regalías por interpretación y ejecución bajo licencias generales. El Licenciante se reserva el derecho exclusivo de autorizar la ejecución pública o la ejecución pública digital de la obra y de recolectar, sea individualmente o a través de una sociedad de gestión colectiva de derechos de autor y derechos conexos (por ejemplo, SAYCO), las regalías por la ejecución pública o por la ejecución pública digital de la obra (por ejemplo Webcast) licenciada bajo licencias generales, si la interpretación o ejecución de la obra está primordialmente orientada por o dirigida a la obtención de una ventaja comercial o una compensación monetaria privada.

ii.	Regalías por Fonogramas. El Licenciante se reserva el derecho exclusivo de recolectar, individualmente o a través de una sociedad de gestión colectiva de derechos de autor y derechos conexos (por ejemplo, los consagrados por la SAYCO), una agencia de derechos musicales o algún agente designado, las regalías por cualquier fonograma que Usted cree a partir de la obra (“versión cover”) y distribuya, en los términos del régimen de derechos de autor, si la creación o distribución de esa versión cover está primordialmente destinada o dirigida a obtener una ventaja comercial o una compensación monetaria privada.

e.	Gestión de Derechos de Autor sobre Interpretaciones y Ejecuciones Digitales (WebCasting). Para evitar toda confusión, el Licenciante aclara que, cuando la obra sea un fonograma, el Licenciante se reserva el derecho exclusivo de autorizar la ejecución pública digital de la obra (por ejemplo, webcast) y de recolectar, individualmente o a través de una sociedad de gestión colectiva de derechos de autor y derechos conexos (por ejemplo, ACINPRO), las regalías por la ejecución pública digital de la obra (por ejemplo, webcast), sujeta a las disposiciones aplicables del régimen de Derecho de Autor, si esta ejecución pública digital está primordialmente dirigida a obtener una ventaja comercial o una compensación monetaria privada.

5. Representaciones, Garantías y Limitaciones de Responsabilidad.
A MENOS QUE LAS PARTES LO ACORDARAN DE OTRA FORMA POR ESCRITO, EL LICENCIANTE OFRECE LA OBRA (EN EL ESTADO EN EL QUE SE ENCUENTRA) “TAL CUAL”, SIN BRINDAR GARANTÍAS DE CLASE ALGUNA RESPECTO DE LA OBRA, YA SEA EXPRESA, IMPLÍCITA, LEGAL O CUALQUIERA OTRA, INCLUYENDO, SIN LIMITARSE A ELLAS, GARANTÍAS DE TITULARIDAD, COMERCIABILIDAD, ADAPTABILIDAD O ADECUACIÓN A PROPÓSITO DETERMINADO, AUSENCIA DE INFRACCIÓN, DE AUSENCIA DE DEFECTOS LATENTES O DE OTRO TIPO, O LA PRESENCIA O AUSENCIA DE ERRORES, SEAN O NO DESCUBRIBLES (PUEDAN O NO SER ESTOS DESCUBIERTOS). ALGUNAS JURISDICCIONES NO PERMITEN LA EXCLUSIÓN DE GARANTÍAS IMPLÍCITAS, EN CUYO CASO ESTA EXCLUSIÓN PUEDE NO APLICARSE A USTED.

6. Limitación de responsabilidad.
A MENOS QUE LO EXIJA EXPRESAMENTE LA LEY APLICABLE, EL LICENCIANTE NO SERÁ RESPONSABLE ANTE USTED POR DAÑO ALGUNO, SEA POR RESPONSABILIDAD EXTRACONTRACTUAL, PRECONTRACTUAL O CONTRACTUAL, OBJETIVA O SUBJETIVA, SE TRATE DE DAÑOS MORALES O PATRIMONIALES, DIRECTOS O INDIRECTOS, PREVISTOS O IMPREVISTOS PRODUCIDOS POR EL USO DE ESTA LICENCIA O DE LA OBRA, AUN CUANDO EL LICENCIANTE HAYA SIDO ADVERTIDO DE LA POSIBILIDAD DE DICHOS DAÑOS. ALGUNAS LEYES NO PERMITEN LA EXCLUSIÓN DE CIERTA RESPONSABILIDAD, EN CUYO CASO ESTA EXCLUSIÓN PUEDE NO APLICARSE A USTED.

7. Término.

a.	Esta Licencia y los derechos otorgados en virtud de ella terminarán automáticamente si Usted infringe alguna condición establecida en ella. Sin embargo, los individuos o entidades que han recibido Obras Derivadas o Colectivas de Usted de conformidad con esta Licencia, no verán terminadas sus licencias, siempre que estos individuos o entidades sigan cumpliendo íntegramente las condiciones de estas licencias. Las Secciones 1, 2, 5, 6, 7, y 8 subsistirán a cualquier terminación de esta Licencia.

b.	Sujeta a las condiciones y términos anteriores, la licencia otorgada aquí es perpetua (durante el período de vigencia de los derechos de autor de la obra). No obstante lo anterior, el Licenciante se reserva el derecho a publicar y/o estrenar la Obra bajo condiciones de licencia diferentes o a dejar de distribuirla en los términos de esta Licencia en cualquier momento; en el entendido, sin embargo, que esa elección no servirá para revocar esta licencia o que deba ser otorgada , bajo los términos de esta licencia), y esta licencia continuará en pleno vigor y efecto a menos que sea terminada como se expresa atrás. La Licencia revocada continuará siendo plenamente vigente y efectiva si no se le da término en las condiciones indicadas anteriormente.

8. Varios.

a.	Cada vez que Usted distribuya o ponga a disposición pública la Obra o una Obra Colectiva, el Licenciante ofrecerá al destinatario una licencia en los mismos términos y condiciones que la licencia otorgada a Usted bajo esta Licencia.

b.	Si alguna disposición de esta Licencia resulta invalidada o no exigible, según la legislación vigente, esto no afectará ni la validez ni la aplicabilidad del resto de condiciones de esta Licencia y, sin acción adicional por parte de los sujetos de este acuerdo, aquélla se entenderá reformada lo mínimo necesario para hacer que dicha disposición sea válida y exigible.

c.	Ningún término o disposición de esta Licencia se estimará renunciada y ninguna violación de ella será consentida a menos que esa renuncia o consentimiento sea otorgado por escrito y firmado por la parte que renuncie o consienta.

d.	Esta Licencia refleja el acuerdo pleno entre las partes respecto a la Obra aquí licenciada. No hay arreglos, acuerdos o declaraciones respecto a la Obra que no estén especificados en este documento. El Licenciante no se verá limitado por ninguna disposición adicional que pueda surgir en alguna comunicación emanada de Usted. Esta Licencia no puede ser modificada sin el consentimiento mutuo por escrito del Licenciante y Usted.
 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