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• Results from failure of the fusion of the caudal neural tube• The causes include chromosome abnormalities, single gene disorders, and teratogenic exposures • Cause is not known in most cases• Up to 70% can be prevented by mother taking folic acid supplements during pregnancy • How the folate works is unknown - likely to involve genes that regulate folate transport and metabolism • Established Risk Factors o History of previous affected pregnancy with same partner o Inadequate maternal intake of folic acid o Pre-gestational maternal diabeteso Valproic acid and carbamazepine

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