Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea.
Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea.
Clin Gastroenterol Hepatol. 2022 Nov;20(11):2542-2550.e8. doi: 10.1016/j.cgh.2021.11.007. Epub 2021 Nov 17.
BACKGROUND & AIMS: Recently, metabolic dysfunction-associated fatty liver disease (MAFLD), rather than nonalcoholic fatty liver disease (NAFLD), was proposed to better describe liver disease associated with metabolic dysfunction (MD). In this study, we attempted to investigate the impact of MAFLD on pregnancy complications.
The current study is a secondary analysis of a multicenter prospective cohort designed to examine the risk of NAFLD during pregnancy. In the first trimester, enrolled pregnant women were evaluated for hepatic steatosis by liver ultrasonography, and blood samples were collected for biochemical measurements. The study population was divided into 3 groups: no NAFLD, hepatic steatosis but without metabolic dysfunction (non-MD NAFLD), and MAFLD. The primary outcome was the subsequent development of adverse pregnancy outcomes, including gestational diabetes mellitus, pregnancy-associated hypertension, preterm birth, and fetal growth abnormalities.
The study population consisted of 1744 pregnant women, including 1523 with no NAFLD, 43 with non-MD NAFLD, and 178 with MAFLD. The risk of subsequent development of adverse pregnancy outcomes was higher in MAFLD than in non-MD NAFLD (adjusted odds ratio, 4.03; 95% CI, 1.68-9.67), whereas the risk was not significantly different between no NAFLD and non-MD NAFLD. Among women with no NAFLD, the presence of MD increased the risk of adverse pregnancy outcomes. However, women with MAFLD were at higher risk for adverse pregnancy outcomes than women with no NAFLD without MD or those with no NAFLD with MD.
In pregnant women, MAFLD may be associated with an increased risk of subsequent adverse pregnancy outcomes.
最近，代谢相关脂肪性肝病（MAFLD）而非非酒精性脂肪性肝病（NAFLD）被提出，以更好地描述与代谢功能障碍相关的肝病。本研究旨在探讨 MAFLD 对妊娠并发症的影响。
本研究为一项多中心前瞻性队列研究的二次分析，旨在研究妊娠期发生 NAFLD 的风险。在妊娠早期，通过肝脏超声检查评估纳入孕妇的肝脂肪变性情况，并采集血样进行生化指标检测。研究人群分为 3 组：无 NAFLD、存在肝脂肪变性但无代谢功能障碍（非 MD-NAFLD）和 MAFLD。主要结局为不良妊娠结局的发生，包括妊娠期糖尿病、妊娠相关性高血压、早产和胎儿生长异常。
研究人群包括 1744 名孕妇，其中 1523 名无 NAFLD、43 名非 MD-NAFLD 和 178 名 MAFLD。与非 MD-NAFLD 相比，MAFLD 患者发生不良妊娠结局的风险更高（调整后比值比，4.03；95%CI，1.68-9.67），而无 NAFLD 与非 MD-NAFLD 之间的风险无显著差异。在无 NAFLD 的孕妇中，存在 MD 会增加不良妊娠结局的风险。然而，与无 MD 的无 NAFLD 孕妇或有 MD 的无 NAFLD 孕妇相比，MAFLD 孕妇发生不良妊娠结局的风险更高。
在孕妇中，MAFLD 可能与不良妊娠结局的风险增加相关。
