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In underdevelopment, adequate caloric intake, smoking restraint, control of drug sales, and decrease of mean maternal age must be added to the list given for development. Since underdeveloped populations have a more relaxed control of ecological aggressions, environmental risks for the fetus are more important here than in developed ones.

Environmental exposures. Known environmental causes of birth defects are limited to ionizing radiation, methylmercury, and lead, producing microcephaly and mental deficiency. However, this lack of proven cause-effect examples may be due to methodological limitations, imposed by factors affecting the whole population within large areas.