Maternal NAFLD ups risk of adverse pregnancy outcomes

Pregnant women with nonalcoholic fatty liver disease (NAFLD) face a greater risk of adverse pregnancy events, suggests a genome-wide association study.

More than 6 million women were assessed in this study, which employed Mendelian randomization (MR) and mediation analyses. The investigators used genetically predicted NAFLD as exposures and cardiometabolic traits as mediators, with various adverse pregnancy events as outcomes.

The inverse variance weighted (IVW) approach was used in the main analysis. Sensitivity analysis was performed using the weighted median, weighted mode, MR-Egger, and MR-PRESSO methods. Finally, a two-step MR framework was used to carry out mediation analyses.

NAFLD showed a robust association with increased risks of gestational diabetes mellitus (p=0.019) and hypertensive disorders of pregnancy (HDP), including any HDP (p<0.001), gestational hypertension (p=0.007), and pre-eclampsia or eclampsia (p=0.040).

However, NAFLD showed no significant associations with haemorrhage in early pregnancy, postpartum haemorrhage, preterm birth, or offspring birthweight for both datasets. In addition, cardiometabolic traits significantly mediated these associations and did not solely act as confounding factors.

“This study provided evidence supporting a correlation between NAFLD and a higher risk of adverse pregnancy events and introduces some new insights,” the investigators said. “These findings may inform preventions and interventions for remediating adverse pregnancy outcomes attributable to NAFLD.”