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When B12 deficiency impairs DNA synthesis, the rapidly dividing epithelial cells cannot regenerate effectively, leading to mucosal thinning, increased fragility, and susceptibility to ulceration

However, vitamin B12 deficiency is quite common among women, particularly vegetarians, vegans, pregnant women, elderly women, and those with digestive disorders

In low-resource nations, iron, folate, vitamin A, and iodine are in scant supply and their deficiency during pregnancy can contribute to multiple adverse outcomes in the mother and newborn

Vegetarians and vegans, since B12 is primarily found in animal-based foods, may experience a deficiency that can become significant over time