NSCL/P etiology, which involves both genetic and envi-ronmental factors, is highly complex; its molecular basisremains largely unknown.2,7The identification of modifiablerisk factors for NSCL/P is the first step toward primary pre-vention. Risk factors such as maternal exposure to tobaccosmoke, alcohol use, poor nutrition, gender, maternal age,viral infection, medicinal drugs, and teratogens in theworkplace or at home in early pregnancy have previouslybeen investigated