Folic acid is crucial to the healthy development of the fetus as it has a direct impact on fetal growth. According to Moussa, Nasab, Haidar, Blackwell, and Sibai, folic acid deficiency can lead to neural tube defects. This term refers to “congenital abnormalities of the brain and spinal column that cause serious mortality and morbidity.” Without a sufficient amount of folic acid in the mother’s body, the fetus is at risk of not having its neural tubes close correctly. This may lead to the incomplete development of the spinal cord or brain. Folic acid deficiency can also affect fetal development by leading to fetal growth restriction. Moussa et al. explain that folate is crucial to fetal growth since it promotes protein, DNA, and lipid synthesis via the homocysteine pathway. A deficiency in folic acid restricts fetal growth, thus also causing developmental abnormalities.
Another critical risk factor is diabetes mellitus. Women with diabetes require rigorous control of the condition during pregnancy, as changes in blood sugar and insulin levels may also have teratogenic effects on the fetus. For example, Márquez-Valadez, Valle-Bautista, García-López, Díaz, and Molina-Hernández note that there is evidence of the negative effect of hyperglycemia on neural tube development. According to research, the inadequate control of diabetes during pregnancy can also result in neural tube defects, leading to underdevelopment of the spinal cord or the brain.