5 Key Takeaways

• 1

  Maternal exposure to solvents and pesticides significantly increases spina bifida risk, while paternal exposure also contributes.

• 2

  Valproic acid is associated with a high risk of spina bifida, even with folic acid supplementation, due to its unique mechanism.

• 3

  Maternal diabetes, smoking, and low vitamin B12 levels are linked to increased spina bifida risk during pregnancy.

• 4

  Genetic variants in folate–homocysteine pathway genes interact with environmental exposures to amplify spina bifida risk.

• 5

  Spina bifida prevalence in the US has decreased due to folic acid fortification, but other risk factors remain significant.