Retrospective Analysis of Diabetic Ketoacidosis in Pregnant Women over a Period of 3 Years

Objective: The incidence of diabetic ketoacidosis in pregnancy (DKP) varies from 0.5%, the lowest reported rate in western countries, to 8.9% in a study conducted in China. The associated fetal mortality is 9-36%. This study aimed to assess the current incidence, causes, and outcomes of diabetic ketoacidosis in pregnancy and identify factors associated with favorable outcomes. Methods: A retrospective chart review of 20 diabetic ketoacidosis hospital admissions of 19 pregnant women from 3,679 diabetic pregnancies delivered between June 2012 and May 2015 was conducted. Those with successful DKP management (group A) or with intrauterine fetal death or urgent delivery during diabetic ketoacidosis management (group B) were compared. Results: Thirteen cases had type 1 diabetes, and 6 cases had type 2 diabetes, including 2 new diagnoses. The most common precipitating factors were vomiting (55%) and insulin non-compliance (45%). Plasma glucose was