Folic acid supplementation reduces the risk of?

Appeared in: RUHS, Jaipur, M.Sc Nursing Entrance Exam-2021

Explanation

Folic acid supplementation is proven to significantly reduce the incidence of neural tube defects (NTDs).
NTDs are birth defects of the brain and spinal cord, such as spina bifida and anencephaly.
Folic acid is critical for DNA synthesis and cell growth, which are essential for the proper closure of the neural tube.
This closure happens very early in pregnancy, between the 3rd and 4th week post-conception, often before a woman knows she is pregnant.
Therefore, periconceptional supplementation (before and during the first trimester) is vital for prevention.

Option B: Toxaemia of pregnancy, or pre-eclampsia, is a hypertensive disorder related to placental and maternal vascular issues. Folic acid is not the primary preventive measure.
Option C: Down's syndrome is a genetic disorder caused by the presence of an extra copy of chromosome 21 (Trisomy 21). It is not caused by a nutritional deficiency.
Option D: Placenta previa is an obstetric complication where the placenta is implanted in the lower uterine segment, covering the cervix. It is not related to folic acid intake.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Role of Folic Acid in Pregnancy as background academic context rather than a clinical decision trigger.
A key nursing role is educating all women of childbearing age about the importance of daily folic acid intake, not just those planning a pregnancy, as many pregnancies are unplanned.
Preconception counseling is the ideal time to initiate folic acid supplementation to ensure adequate levels before the neural tube closes.
Nurses must assess for high-risk factors, such as a previous NTD-affected pregnancy or use of medications like valproic acid, which require a higher dose of folic acid.

How to Approach the Question

First, identify the core concept of the question, which is the preventive role of folic acid supplementation.
Recall knowledge about prenatal care and nutrition. Folic acid is one of the most well-known supplements for pregnancy.
Think about the specific condition that folic acid is famous for preventing. This is a common public health topic.
Evaluate each option: 'Neural tube defect' is directly linked to folic acid deficiency. 'Toxaemia', 'Down's syndrome', and 'Placenta previa' have different, unrelated causes (hypertension/placental issues, genetics, and placental implantation site, respectively).
Select the option that represents the primary, evidence-based reason for widespread folic acid supplementation recommendations for women of childbearing age.

Concept Tested & Keywords

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E6 Nelson Textbook of Pediatrics(2024) — Volume 2 p. 1367-1369

E6 Pharmacology Katzung 16e p. 935-937

E6 Nelson Textbook of Pediatrics(2024) — Volume 1 p. 1036-1038

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