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More critically, this masking, although neither complete nor permanent, can permit neurologic dysfunction to develop and sometimes become irreversible

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[12] [10] Cyanocobalamin was first manufactured in the 1940s

A 2024 Cochrane Database review of five clinical trials included 984 pregnant women from low- and middle-income countries (including India, Bangladesh, South Africa, and Croatia) in which 26% to 51% had vitamin B 12 deficiency (less than 150 pmol/L) and 30% to 46% had anemia (hemoglobin less than 11.0 g/dL) at enrollment (88)