962-P: Plasma Beta Hydroxybutyrate in Pregnancy and Gestational Diabetes

2021 
Background: Insulin resistance in pregnancy may be related to ketone synthesis. Data on ketone production in pregnancy and whether they are associated with gestational diabetes (GDM) risk is limited. Methods: A matched case-control study of 107 GDM cases and 214 controls was conducted within the NICHD Fetal Growth Studies-Singleton Cohort. Beta hydroxybutyrate (BOH, mmol/L) was measured 4 times in plasma collected at gestational weeks (GW) 10-14, 15-26 (fasted), 23-31, and 33-39. GDM diagnosis and glucose challenge test (GCT) results were extracted from medical records. Prevalence of undetectable ( Results: Percent of women with undetectable, detectable, elevated, and ketoacidosis BOH was 41%, 47%, 10%, and 2% at GW 10-14; 37%, 46%, 15%, and 2% at GW 15-26; 48%, 43%, 9%, and 0% at GW 23-31; and 37%, 57%, 6%, 0% at GW 33-39. Ketoacidosis at 10-14 GW was associated with higher GCT levels (Table). Conclusions: Although few women develop ketoacidosis in pregnancy, detectable ketone levels are common in pregnancy. First trimester ketoacidosis was prospectively associated with higher GCT glucose at GDM screening. Disclosure S. Hinkle: None. S. F. Yisahak: None. S. Zhao: None. M. Y. Tsai: None. C. Zhang: None. Funding Eunice Kennedy Shriver National Institute of Child Health and Human Development
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