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Appropriate caution should be exercised while treating severe megaloblastic anemia with cyanocobalamin as intense treatment may lead to hypokalemia and sudden death

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In the first year following diagnosis, we found increased cumulative incidence risk ratios in a number of outcomes including: - Any mental, behavioural, or neurodevelopmental disorder 1.96 (1.93 - 1.99) - Postpartum depression 2.70 (2.61 - 2.79) - Eating disorders 2.06 (1.85 - 2.89) - PTSD 1.77 (1.69 - 1.86) We also saw significantly increased risk in rare but serious outcomes such as: - Wernicke's encephalopathy 2.39 (1.25 - 4.56) - Puerperal psychosis 1.80 (1.48 - 2.20) Interestingly, cases of hyperemesis gravidarum with metabolic disturbance displayed a significantly lower risk of any depression and postpartum depression compared with those without metabolic disturbance