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  1. There is one published report of two pregnant women using a keto diet to control epilepsy. One woman had a baby with normal development, followed all the way to 12 months of age. The other woman’s baby had bilateral ear deformities of unknown cause, though her anti-seizure drug dose did need to be increased a total of three times during the latter two-thirds of her pregnancy.

    Seizure 2017: Ketogenic diet therapy for epilepsy during pregnancy: A case series [case series report; very weak evidence]

  2. Rodent studies report that the ketogenic diet may increase or decrease the rate of growth and development of multiple organs. The significance of these findings with respect to any impact on cognitive, motor, and behavioral function is unclear. One of the rodent studies found the adult offspring of mothers fed a keto diet to be hyperactive, less depressed, and less anxious.

    BMC Pregnancy Childbirth. 2013: Effects of a ketogenic diet during pregnancy on embryonic growth in the mouse [animal study; very weak evidence]

    Brain Behav. 2015: Gestational ketogenic diet programs brain structure and susceptibility to depression & anxiety in the adult mouse offspring [animal study; very weak evidence]

  3. Obstet Gynecol. 2014: Diabetic ketoacidosis in pregnancy [overview article; ungraded]

    Eur J Obstet Gynecol Reprod Biol. 2013: Starvation ketoacidosis in pregnancy [overview article; ungraded]

  4. Womens Health Issues. 2013: Enrolling Pregnant Women: Issues in Clinical Research [overview article; ungraded]

    BMC Med Ethics. 2017: A qualitative study on acceptable levels of risk for pregnant women in clinical research[non-controlled study; weak evidence]

  5. Front Pediatr. 2017: Pregnancy: An Underutilized Window of Opportunity to Improve Long-term Maternal and Infant Health—An Appeal for Continuous Family Care and Interdisciplinary Communication [overview article; ungraded]

    Lancet. 2005: Cardiovascular health after maternal placental syndromes (CHAMPS): population-based retrospective cohort study [observational study; weak evidence]

    JRSM Short Rep. 2012: The fetal origins of adult disease: a narrative review of the epidemiological literature [overview article; ungraded]

  6. American Pregnancy Organization: Dieting During Your Pregnancy [overview article; ungraded]

    Open Cardiovasc Med J. 2011: Nutrition During Pregnancy and the Effect of Carbohydrates on the Offspring’s Metabolic Profile: In Search of the “Perfect Maternal Diet” [overview article; ungraded]

  7. BMC Pregnancy Childbirth. 2013: Effects of a ketogenic diet during pregnancy on embryonic growth in the mouse [animal study; very weak evidence]

    Brain Behav. 2015: Gestational ketogenic diet programs brain structure and susceptibility to depression & anxiety in the adult mouse offspring [animal study; very weak evidence]

  8. Obesity Reviews 2020: Scientific evidence underlying contraindications to the ketogenic diet: An update [overview article; ungraded]

  9. Seizure 2017: Ketogenic diet therapy for epilepsy during pregnancy: A case series [case series report; very weak evidence]

  10. Nutrients 2020: Choline, Neurological Development and Brain Function: A Systematic Review Focusing on the First 1000 Days [systematic review, strong evidence]

  11. This is based on his clinical experience and not on scientific studies.

  12. This is based on his opinion and clinical experience and not on scientific studies

  13. [anecdotal report; very weak evidence]

  14. Maria is not a medical doctor but rather is an experienced low-carb nutritional coach. Comments by her and the doctors quoted in this article are not meant as individual medical advice. They are presented as general information to help you make the best decision together with your doctor.

  15. Ann Biol Clin (Paris). 2007: [Feto-maternal metabolism in human normal pregnancies: study of 73 cases] [non-controlled study; weak evidence]

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  17. This is based on her clinical experience

  18. [anecdotal reports; very weak evidence]

  19. These are ‘Keto pregnacy Keto Mom‘ and
    Ketopregnancy & Breastfeeding‘.