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Research Foundation of Shenzhen Hospital, Southern Medical University (PY2020YM02), and Research Promotion Funds for the Key Discipline Construction Program (ZDXKKYTS007) provided funding in the writing and revision of the manuscript

The dosing regimen varies depending on whether neurological symptoms are present: With neurological involvement: 1 mg intramuscularly on alternate days until no further improvement, then 1 mg every 2 months [3] [4] Without neurological involvement: 1 mg intramuscularly three times a week for 2 weeks, then 1 mg every 2-3 months for maintenance [3] [4] There is some evidence that high-dose oral B12 (1000-2000 micrograms daily) may be effective even in some malabsorption conditions, though UK practice still generally favours intramuscular treatment in these cases

Pyridoxine HCl Injection should be stored in accordance with standard recommendations for vitamin solutions to maintain its potency

Complications in pregnancy (neural tube defects, recurrent miscarriages, preeclampsia, intrauterine growth retardation)