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In a cohort of pregnant women in Bangalore, India, with a high incidence of vitamin B-12 deficiency, we reported previously that women in the lowest tertile for plasma vitamin B-12 concentration during all 3 trimesters of pregnancy had significantly higher risk of IUGR that persisted after adjusting for maternal age, weight, education, and parity (12)

Since multiple injections are usually required, the total cost of treatment can be significant

Patient Experience Nasal Spray: Pros: The minimally invasive nature and the avoidance of needles make nasal sprays an attractive option for many, enhancing the overall patient experience and favorability towards this supplementation method

From a health economics perspective, lifelong B12 supplementation should involve cost-effective delivery routes and tailored dosages to optimise clinical outcomes while minimising excess

This layered approach often leads to more efficient and sustained results