Ketones in Pregnancy: Why Is It Considered Necessary to Avoid Them and What Is the Evidence Behind Their Perceived Risk? | Zendy

Helen Tanner | Zendy; Marloes Dekker Nitert | Zendy; Leonie Callaway | Zendy; Helen L. Barrett | Zendy

Open Access

Ketones in Pregnancy: Why Is It Considered Necessary to Avoid Them and What Is the Evidence Behind Their Perceived Risk?

Author(s) -

Helen Tanner,

Marloes Dekker Nitert,

Leonie Callaway,

Helen L. Barrett

Publication year - 2020

Publication title -

diabetes care

Language(s) - English

Resource type - Journals

SCImago Journal Rank - 6.636

H-Index - 363

eISSN - 1935-5548

pISSN - 0149-5992

DOI - 10.2337/dc20-2008

Subject(s) - ketogenesis , medicine , pregnancy , gestational diabetes , diabetes mellitus , ketone bodies , fetus , obstetrics , gestation , pediatrics , endocrinology , metabolism , biology , genetics

Current dietary advice for women with gestational diabetes mellitus is to avoid diets that result in elevated ketone levels. This guidance stems from a concern that maternal ketones are associated with poor fetal and childhood outcomes, including reduced childhood intelligence quota. The evidence behind these guidelines is conflicting and inconsistent. Given that dietary counseling is the initial treatment strategy for women with diabetes in pregnancy, it is important that clinicians understand the concern regarding maternal ketones. This review examines the physiology of ketogenesis in pregnancy, the prevalence of elevated maternal ketone levels, and the relationship between maternal ketones and fetal and childhood outcomes.

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