The impact of maternal ketonuria with pregnancy outcome and optimal carbohydrate intake in pregnant women
Year: 2025
Type: article
Study design: Observational Study
Abstract: Background Ketonuria during pregnancy, potentially arising from inadequate carbohydrate intake or elevated energy demands, has an uncertain association with adverse outcomes, particularly preterm birth. Aims This study aimed to examine the relationship between maternal ketonuria and pregnancy outcomes, and to identify the carbohydrate intake level that may help prevent ketonuria in pregnant women. Methods In this prospective study, 349 pregnant women were assessed for ketonuria using the nitroprusside method, categorized into mild, moderate, and severe. Dietary carbohydrate intake was measured via a food frequency questionnaire. Receiver operating characteristic analysis identified trimester-specific carbohydrate thresholds for moderate/severe ketonuria. Logistic regression evaluated associations between ketonuria and preterm birth, adjusting for confounders including prepregnancy body mass index (BMI), smoking, blood pressure, hemoglobin, and glucose levels. Results Ketonuria prevalence was 12.6% (mild), 1.7% (moderate), and 2.3% (severe). Ketonuria was associated with higher prepregnancy BMI, smoking history, and increased preterm birth. First-trimester ketonuria significantly increased preterm birth risk (adjusted OR 5.76; 95% CI [1.73–19.1]; p = .004). Carbohydrate intake thresholds predicting moderate/severe ketonuria were 187 g (first trimester), 170 g (second), and 143 g (third). Conclusions Early pregnancy ketonuria is independently associated with preterm birth. Adequate trimester-specific carbohydrate intake may help prevent ketonuria, highlighting its importance in prenatal care.
Source: Nutrition and Health
Institutions: Kyoto Medical Center, Kyoto Kacho University
Language: English
Subfield: Obstetrics and Gynecology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
Awards: Development of a diabetes education program using the real-time continuous glucose monitoring, G6817587895, Development of a personalized diabetes management program combining continuous glucose monitoring and breath acetone measurement., Elucidation of dietary habits during pregnancy aimed to prevent postpartum depression with a view to precision health
OpenAlex ID: W4415220082