Endocrine · 2026
Clinical course and outcomes of diabetic ketoacidosis in pregnancy: a single-center experience.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Sonu Nevda Ceren, Orhan Nazli, Kahveci Sanem Ozcan, Farisogullari Nihat, Tokalioglu Eda Ozden, Ozcan Namik Nebi, Sahin Dilek
Аннотация
PURPOSE: We evaluated the obstetric and perinatal outcomes of pregnant women hospitalised with diabetic ketoacidosis (DKA) and examined the association between clinical and laboratory parameters and admission to the intensive care unit (ICU).
METHODS: This retrospective observational study included 32 pregnant women managed for DKA between May 2019 and December 2025 at Ankara Bilkent City Hospital, comparing those admitted to the ICU with those who were not. The association of arterial pH and serum bicarbonate with ICU admission was examined using ROC analysis and logistic regression, and biochemical severity markers were compared between pregnancies with and without DKA-related adverse outcomes. Given the sample size, all inferential analyses were regarded as exploratory.
RESULTS: Twenty women (62.5%) were admitted to the ICU. They were older and had lower arterial pH and serum bicarbonate, whereas plasma glucose did not differ between groups. Thresholds examined were ≤ 18.5 mmol/L for bicarbonate (AUC 0.80, 95% CI 0.65-0.95) and ≤ 7.33 for pH (AUC 0.72, 95% CI 0.53-0.90). In a two-variable logistic regression model, lower bicarbonate (OR 0.58, 95% CI 0.37-0.91) and older age (OR 1.49, 95% CI 1.07-2.08) were associated with ICU admission. Women with DKA-related adverse outcomes had lower pH (7.20 versus 7.34; p = 0.004) and lower bicarbonate (8.0 versus 17.0 mmol/L; p = 0.014).
CONCLUSION: In this small single-centre cohort, the depth of maternal acidosis rather than the degree of hyperglycaemia was associated with ICU admission and with adverse obstetric outcomes. These findings are exploratory and hypothesis-generating; the thresholds reported here require validation in larger, multicentre cohorts before any clinical application.
METHODS: This retrospective observational study included 32 pregnant women managed for DKA between May 2019 and December 2025 at Ankara Bilkent City Hospital, comparing those admitted to the ICU with those who were not. The association of arterial pH and serum bicarbonate with ICU admission was examined using ROC analysis and logistic regression, and biochemical severity markers were compared between pregnancies with and without DKA-related adverse outcomes. Given the sample size, all inferential analyses were regarded as exploratory.
RESULTS: Twenty women (62.5%) were admitted to the ICU. They were older and had lower arterial pH and serum bicarbonate, whereas plasma glucose did not differ between groups. Thresholds examined were ≤ 18.5 mmol/L for bicarbonate (AUC 0.80, 95% CI 0.65-0.95) and ≤ 7.33 for pH (AUC 0.72, 95% CI 0.53-0.90). In a two-variable logistic regression model, lower bicarbonate (OR 0.58, 95% CI 0.37-0.91) and older age (OR 1.49, 95% CI 1.07-2.08) were associated with ICU admission. Women with DKA-related adverse outcomes had lower pH (7.20 versus 7.34; p = 0.004) and lower bicarbonate (8.0 versus 17.0 mmol/L; p = 0.014).
CONCLUSION: In this small single-centre cohort, the depth of maternal acidosis rather than the degree of hyperglycaemia was associated with ICU admission and with adverse obstetric outcomes. These findings are exploratory and hypothesis-generating; the thresholds reported here require validation in larger, multicentre cohorts before any clinical application.