護理師為一位懷孕 10 週的個案提供衛教。下列哪種營養補充劑對於預防胎兒神經管缺陷最為關鍵？
The nurse is providing education to a pregnant client at 10 weeks gestation. Which nutritional supplement is most critical to prevent neural tube defects?
- AFolic acid✓ 正解葉酸
- BCalcium鈣
- CVitamin C維生素 C
- DIron鐵
葉酸 (Folic acid) 是細胞分裂與 DNA 合成的必需輔酶。在懷孕初期甚至受孕前，充足的葉酸攝取能顯著降低胎兒神經管缺陷 (NTDs) 如脊柱裂的風險。雖然個案目前已懷孕 10 週，神經管已閉合，但持續補充葉酸仍有助於紅血球生成與胎盤發育。選項 D (鐵) 主要是預防貧血；選項 C (維生素 C) 輔助鐵吸收；選項 B (鈣) 維護骨骼，但皆非預防神經管缺陷的核心。護理師應指導育齡女性在計畫懷孕時即開始每天攝取 400-800 mcg 葉酸。
Folic acid is an essential coenzyme for cell division and DNA synthesis. Adequate folic acid intake in early pregnancy and even before conception significantly lowers the risk of fetal neural tube defects (NTDs), such as spina bifida. Although this client is already 10 weeks pregnant and the neural tube has closed, continued folic acid supplementation still supports erythropoiesis and placental development. Option D (iron) is mainly for preventing anemia; option C (vitamin C) supports iron absorption; option B (calcium) maintains bones, but none of these is the core agent for preventing neural tube defects. The nurse should advise women of childbearing age to begin taking 400-800 mcg of folic acid daily when planning pregnancy.
美國許多食品（如麵粉）規定必須強化葉酸，因此日常攝取量較高；台灣則強調透過葉酸補充劑或深綠色蔬菜攝取。兩地護理師在衛教時都應詢問病人是否已有服用孕婦綜合維他命。