Sample size limited our power to detect significant differences between study groups; however, few studies have investigated associations between placental/fetal MTHFR variants and PE/IUGR and NTD pathologies in the Canadian population post-folic acid fortification, and the main focus of the current research was to assess altered placental DNAm in association with high-risk MTHFR genotypes. Here, MTHFR is linked to neural tube defect.