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That hypothesis stimulated considerable research over the last 15 years, leading to the production of more than 50 case-control studies that, despite the conflicting nature of their results, revealed a complexity of gene-gene and gene-nutrient interactions in folate metabolism as potential maternal risk factors for having a birth with trisomy for chromosome 21 (Table 1)

Patients should review current FDA updates and discuss all options - including brand-name alternatives - with a licensed clinician

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