Bihar CHO - 2021
Obstetrics & Gynaecology
Easy

Which nutrient or vitamin supplement during pregnancy can reduce the risk of Neural Tube Defect (NTD) in the fetus?

Appeared in: Bihar CHO - 2021

Explanation

  • Folic acid (a B vitamin) is crucial for the proper closure of the neural tube in the early weeks of fetal development (3-4 weeks post-gestation).
  • Inadequate folate levels are a well-established risk factor for neural tube defects (NTDs) such as spina bifida (incomplete closure of the spinal cord) and anencephaly (absence of a major portion of the brain).
  • Supplementation is most effective when started at least one month before conception and continued through the first 12 weeks of gestation, which is the critical period for neural tube formation.
  • Due to its proven effectiveness, daily folic acid supplementation is a standard public health recommendation for all women of childbearing potential.

Why Other Options Were Wrong

  • Option A: Calcium is essential for fetal skeletal development (bones and teeth) and maintaining maternal bone health, but it has no role in the closure of the neural tube.
  • Option B: Magnesium is a cofactor in many enzymatic reactions and supports maternal muscle and nerve function. It is not involved in the prevention of NTDs.
  • Option C: Iron is vital for hemoglobin synthesis to support the expanded maternal blood volume and provide oxygen to the fetus. Its primary role is to prevent and treat iron-deficiency anemia.

Related Visual

Visual explanation — Related Visual
Clinical Relevance
  • Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Nutritional supplementation in pregnancy for neural tube defect (NTD) prevention as background academic context rather than a clinical decision trigger.
  • Nurses play a vital role in preconception and antenatal counseling, educating all women of childbearing age about the critical importance of daily folic acid intake, as many pregnancies are unplanned.
  • A key nursing responsibility is to assess for high-risk factors (e.g., a previous pregnancy affected by an NTD, maternal diabetes, use of anti-epileptic drugs like valproate) that necessitate a higher prescription dose of folic acid (4 mg/day).
  • Patient education should include both supplementation and dietary sources of folate, such as fortified grains, leafy greens, and legumes, to ensure adequate intake.
How to Approach the Question
  • First, identify the key terms in the question: 'nutrient/vitamin', 'pregnancy', and 'reduce the risk of Neural Tube Defect (NTD)'.
  • The question asks for a specific preventative measure for a specific condition.
  • This is a direct factual recall question, a cornerstone of antenatal care knowledge.
  • Systematically review the options and recall the primary function of each during pregnancy.
  • Calcium is for bones. Iron is for blood (anemia). Magnesium has roles in muscle function and is used therapeutically for preeclampsia.
  • Recall that Folic Acid is uniquely and directly linked to the prevention of neural tube defects.
Concept Tested & Keywords
  • Concept Tested: Nutritional supplementation in pregnancy for neural tube defect (NTD) prevention
  • Stem keywords: nutrient, vitamin supplement, pregnancy, Neural Tube Defect, NTD, fetus
  • Lead-in keywords: Which

Question ID

QpQpqpsZD3Z73HcR-P-u4U

Reference Book

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

E6 Obstetrics Williams p. 81-95

E6 Biochemistry U Satyanarayana— Part 2 (pp 421-820 of 840) p. 139-141

Practise the full Bihar CHO - 2021

Attempt every question from this paper in a timed mock, then review the full solution for each one.

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