{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T22:20:48Z","timestamp":1788387648391,"version":"build-2803163510"},"reference-count":0,"publisher":"American Diabetes Association","issue":"11","content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[1998,11,1]]},"abstract":"<jats:p>OBJECTIVE: The objective was to assess relationships between beta-hydroxybutyrate (beta-OHB) level and pregnancy outcome in human pregnancy in light of the fact that high levels of beta-OHB cause malformations and growth retardation in in vitro studies. RESEARCH DESIGN AND METHODS: We analyzed beta-OHB in prospectively collected specimens from the National Institute of Child Health and Human Development-Diabetes in Early Pregnancy Study, in gestational weeks 6-12 in diabetic (n = 204-239) and nondiabetic (n = 316-332) pregnant women. RESULTS: Levels of beta-OHB in diabetic women were 2.5-fold higher than in nondiabetic pregnant women at 6 weeks' gestation and declined to 1.6-fold above nondiabetic women by 12 weeks' gestation (P &amp;lt; 0.0001 at all times). beta-OHB was positively correlated with glucose levels (P &amp;lt; 0.0001) in diabetic mothers, probably reflecting degree of diabetic control. beta-OHB correlated inversely with glucose (P &amp;lt; 0.0003) (gestational week 6 only) in nondiabetic mothers, possibly reflecting caloric intake. beta-OHB tended to be lower (not higher) in diabetic and nondiabetic mothers with malformed infants or pregnancy losses, but the difference was not statistically significant. beta-OHB in diabetic mothers at 8, 10, and 12 weeks correlated inversely with birth weight (P = 0.004-0.02), even after adjusting for maternal glucose levels. beta-OHB levels were also generally lower in diabetic mothers of macrosomic infants, and week 12 ultrasound crown-rump measurements were inversely related to beta-OHB levels. CONCLUSIONS: The lst trimester beta-OHB is significantly higher in diabetic than nondiabetic pregnant women. In both groups, beta-OHB tended to be lower, not higher, in mothers who had a malformed infant or pregnancy loss. beta-OHB was inversely related to crown-rump length and birth weight. The modest beta-OHB elevation in the 1st trimester of reasonably well-controlled diabetic pregnancy is not associated with malformations, probably because beta-OHB levels causing malformations in embryo culture models are 20- to 40-fold higher. The mechanism of the beta-OHB association with impaired fetal growth is unknown.<\/jats:p>","DOI":"10.2337\/diacare.21.11.1978","type":"journal-article","created":{"date-parts":[[2007,3,5]],"date-time":"2007-03-05T22:51:27Z","timestamp":1173135087000},"page":"1978-1984","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":76,"title":["The Diabetes in Early Pregnancy Study: beta-hydroxybutyrate levels in type 1 diabetic pregnancy compared with normal pregnancy. NICHD-Diabetes in Early Pregnancy Study Group (DIEP). National Institute of Child Health and Development."],"prefix":"10.2337","volume":"21","author":[{"given":"L","family":"Jovanovic","sequence":"first","affiliation":[{"name":"Sansum Medical Research Institute, Santa Barbara, California 93105, USA. lois@sansumres.com"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B E","family":"Metzger","sequence":"additional","affiliation":[{"name":"Sansum Medical Research Institute, Santa Barbara, California 93105, USA. lois@sansumres.com"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R H","family":"Knopp","sequence":"additional","affiliation":[{"name":"Sansum Medical Research Institute, Santa Barbara, California 93105, USA. lois@sansumres.com"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M R","family":"conley","sequence":"additional","affiliation":[{"name":"Sansum Medical Research Institute, Santa Barbara, California 93105, USA. lois@sansumres.com"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E","family":"Park","sequence":"additional","affiliation":[{"name":"Sansum Medical Research Institute, Santa Barbara, California 93105, USA. lois@sansumres.com"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Y J","family":"Lee","sequence":"additional","affiliation":[{"name":"Sansum Medical Research Institute, Santa Barbara, California 93105, USA. lois@sansumres.com"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J L","family":"Simpson","sequence":"additional","affiliation":[{"name":"Sansum Medical Research Institute, Santa Barbara, California 93105, USA. lois@sansumres.com"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L","family":"Holmes","sequence":"additional","affiliation":[{"name":"Sansum Medical Research Institute, Santa Barbara, California 93105, USA. lois@sansumres.com"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J H","family":"Aarons","sequence":"additional","affiliation":[{"name":"Sansum Medical Research Institute, Santa Barbara, California 93105, USA. lois@sansumres.com"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J L","family":"Mills","sequence":"additional","affiliation":[{"name":"Sansum Medical Research Institute, Santa Barbara, California 93105, USA. lois@sansumres.com"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1167","container-title":["Diabetes Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/diabetesjournals.org\/care\/article-pdf\/21\/11\/1978\/447412\/9802754.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/diabetesjournals.org\/care\/article-pdf\/21\/11\/1978\/447412\/9802754.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,3,12]],"date-time":"2022-03-12T15:25:52Z","timestamp":1647098752000},"score":1,"resource":{"primary":{"URL":"https:\/\/diabetesjournals.org\/care\/article\/21\/11\/1978\/23056\/The-Diabetes-in-Early-Pregnancy-Study-beta"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1998,11,1]]},"references-count":0,"journal-issue":{"issue":"11","published-print":{"date-parts":[[1998,11,1]]}},"URL":"https:\/\/doi.org\/10.2337\/diacare.21.11.1978","relation":{},"ISSN":["0149-5992","1935-5548"],"issn-type":[{"value":"0149-5992","type":"print"},{"value":"1935-5548","type":"electronic"}],"subject":[],"published":{"date-parts":[[1998,11,1]]}}}