The following pregnant patients are at increased risk of NTDs and might benefit from higher doses of folic acid:

Patients with ... specific genotypes associated with higher risk of NTDs previous pregnancies with NTDs or family history of NTDs malabsorption disorders (eg, inflammatory bowel disease) obesity with BMI > 35 kg/m2 diabetes compliance and lifestyle issues

Patients who ... take antiepileptic drugs take folate antagonists (eg, methotrexate, sulfonamides) smoke belong to high-risk ethnic groups (eg, Sikh, Celtic, Northern Chinese)

BMI—body mass index, NTD—neural tube defect.