NAFLD, regardless of obesity status, ups risk of adverse pregnancy outcomes

Women with nonalcoholic fatty liver disease (NAFLD), despite having a normal weight, remains at greater risk of adverse pregnancy outcomes, reveals a study.

A team of investigators sought to assess the association between maternal NAFLD and adverse pregnancy outcomes in different body mass index (BMI) groups. Using an antenatal care and delivery database, they retrospectively analysed women who gave birth between 1 January 2013 and 30 June 2020 at Minhang Hospital, Fudan University, Shanghai, China.

Ultrasound in early pregnancy confirmed NAFLD. Potential associations between NAFLD and pregnancy outcomes were examined using a logistic regression model with adjustment for confounders.

Of the 14,708 pregnant women (mean prepregnant BMI, 21.0 kg/m²) included in the analysis, 554 (3.8 percent) had NAFLD.

NAFLD significantly correlated with a higher risk of gestational diabetes mellitus (adjusted odds ratio [aOR], 2.477, 95 percent confidence interval [CI], 1.885‒3.254), gestational hypertension (aOR, 3.054, 95 percent CI, 2.191‒4.257), pre-eclampsia/eclampsia (aOR, 3.994, 95 percent CI, 2.591‒6.005), caesarean section (aOR, 1.569, 95 percent CI, 1.315‒1.872), preterm births (aOR, 1.831, 95 percent CI, 1.229‒2.727), and macrosomia (aOR, 1.691, 95 percent CI, 1.300‒2.198).

Notably, although 12,338 women (83.9 percent) were of normal weight at the start of pregnancy (prepregnant 18.5 ≤ BMI < 24 kg/m²), they still had an increased risk for adverse pregnancy outcomes.

“Pregnant women with NAFLD, regardless of obesity status, should be offered a more qualified surveillance to optimize pregnancy outcomes,” the investigators said.