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However, despite increasing awareness of the benefits of folic acid supplementation and the implementation of food fortification programs in many countries, NTDs continue to be a leading cause of perinatal morbidity and mortality worldwide. Furthermore, there exists a significant subgroup of women who appear to be resistant to the protective effects of folic acid supplementation. The following review addresses emerging clinical and experimental evidence for a role of the immune system in the etiopathogenesis of NTDs, with the aim of developing novel preventative strategies to further reduce the incidence of NTD\u2010affected pregnancies. In particular, recent studies demonstrating novel roles and interactions between innate immune factors such as the complement cascade, neurulation, and folate metabolism are explored. <jats:italic>Birth Defects Research (Part A) 97:602\u2013609, 2013<\/jats:italic>. \u00a9 2013 Wiley Periodicals, Inc.<\/jats:p>","DOI":"10.1002\/bdra.23177","type":"journal-article","created":{"date-parts":[[2014,1,6]],"date-time":"2014-01-06T10:29:31Z","timestamp":1389004171000},"page":"602-609","source":"Crossref","is-referenced-by-count":39,"title":["Neural tube defects, folate, and immune modulation"],"prefix":"10.1002","volume":"97","author":[{"given":"Kerina J.","family":"Denny","sequence":"first","affiliation":[{"name":"School of Biomedical Sciences The University of Queensland St Lucia Brisbane Australia"},{"name":"Royal Brisbane and Women's Hospital Herston Brisbane 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