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These include: Family history of cleft lip or palate Maternal smoking or alcohol use during pregnancy Gestational diabetes Exposure to certain medicines or toxins during pregnancy, including dioxin, phenytoin, valproic acid, retinoic acid, and thalidomide Nutritional deficiencies during pregnancy Prenatal viral illness Advanced maternal age Consanguineous marriage (Marriage between closely related relatives) Boys are more likely to have cleft lip, but girls are more likely to have cleft palate How to Prevent Cleft Lip and Palate During Pregnancy