Spina bifida risk factors
1. Maternal nutrition factors:
Alcohol use
Caffeine use
Low folate intake
Low dietary quality
Elevated glycaemic load or index
Low methionine intake
Low serum choline level
Low serum vitamin B12 level
Low vitamin C level
Low zinc intake
Smoking
Hyperthermia
Low socio-economic status
Maternal infections and illnesses
Pregestational insulin-dependent diabetes
Pregestational obesity
Psychosocial stress
Valproic acid use
2. Environmental factors
Ambient air pollution215,216
Disinfectant by-products in drinking water217
Indoor air pollution218
Nitrate-related compounds219
Organic solvents220
Pesticides221,222
Polycyclic aromatic hydrocarbons223