The etiology of spina bifida is heterogeneous [147–150]. Most nonsyndromic spina bifida is thought to be of multifactorial origin  with influence of both genetic and environmental factors [144, 152]. Among the environmental factors associated with increased risk of spina bifida are increased pregnancy weight [153–158], maternal smoking [159–161], drug intake specifically of antiepileptic drugs [162–164], and maternal illnesses such as diabetes [165, 166] and hyperthermia . Dietary factors including water chlorination [168–170], inositol intake , simple sugar intake , and the intake of trace elements and other micronutrients [173–176] have been proposed to act as either contributory or preventive factors for spina bifida. Isolated spina bifida is caused by cytogenetic abnormalities in 2–16% of cases [177–179].