Which of the following nutrient’s inadequate intake in pregnancy leads to neural tube defects in fetus?

NIA - 29 January 2023

Obstetrics & Gynaecology

Easy

Appeared in: NIA - 29 January 2023

Explanation

Folic acid (Vitamin B9) is the correct answer as its deficiency is directly linked to the development of neural tube defects (NTDs).
The neural tube forms the early brain and spine, and its closure is a critical developmental milestone that occurs within the first 28 days of pregnancy.
Folic acid is essential for DNA synthesis, cell growth, and cell division, processes that are highly active during the formation and closure of the neural tube.
Insufficient folic acid during this critical period can lead to incomplete closure of the neural tube, resulting in defects like spina bifida or anencephaly.

Option A: Iron deficiency in pregnancy is a common and serious issue, but it primarily leads to maternal iron-deficiency anemia and is associated with low birth weight and preterm delivery, not neural tube defects.
Option C: Vitamin B12 works closely with folic acid in DNA synthesis. While severe Vitamin B12 deficiency can cause megaloblastic anemia and neurological problems, and some studies suggest it may be an independent risk factor for NTDs, it is not considered the primary cause. Folic acid deficiency is the most direct and significant nutritional cause.
Option D: Calcium is vital during pregnancy for the development of the fetus's bones, teeth, heart, nerves, and muscles. Inadequate calcium intake can lead to poor fetal bone mineralization and may increase the mother's risk for pre-eclampsia, but it does not cause neural tube defects.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain The role of micronutrients in preventing congenital anomalies during pregnancy as background academic context rather than a clinical decision trigger.
The key nursing intervention is patient education. Nurses must educate all women of childbearing age about the importance of taking folic acid supplements before becoming pregnant to prevent NTDs.
This is a critical public health message because nearly half of all pregnancies are unplanned, and the neural tube closes before many women realize they are pregnant.
Nurses should assess dietary habits and recommend folate-rich foods (leafy green vegetables, citrus fruits, beans, fortified cereals) in addition to supplementation.

How to Approach the Question

This is a factual recall question common in nursing exams.
First, identify the keywords in the question: 'inadequate intake,' 'pregnancy,' and 'neural tube defects.'
The term 'neural tube defects' is the most specific clinical clue.
Recall the specific vitamin directly linked to the prevention of this type of birth defect.
Evaluate the options: Iron (anemia), Folic acid (NTDs), Vitamin B12 (anemia, neurological issues), and Calcium (bones).
Select the option with the strongest and most direct causal link to neural tube defects, which is Folic acid.

Concept Tested & Keywords

Concept Tested: The role of micronutrients in preventing congenital anomalies during pregnancy.
Stem keywords: nutrient, inadequate intake, pregnancy, neural tube defects, fetus
Lead-in keywords: Which
Negative lead-in flag: false

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E6 Obstetrics Williams p. 81-95

E6 Parks TextBook of Preventive & Social Medicine part 2 — Subpart A (pp 1-232 of 464) p. 155-157