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Early life programming of nonalcoholic fatty liver disease in children
Safiya Soullane1, Philippe Willems2, Ga Eun Lee3
1Faculty of Medicine, McGill University, 3605 Mountain St, Montreal, Quebec H3G 2M1, Canada.
Insights
Maternal diabetes, obesity, and prematurity are linked to childhood nonalcoholic fatty liver disease. These perinatal factors may initiate early-life processes contributing to the condition
Area of Science:
- Pediatric Gastroenterology and Hepatology
- Perinatal Medicine
- Metabolic Disorders
Background:
- Early life factors are increasingly linked to pediatric nonalcoholic fatty liver disease (NAFLD).
- The specific role of perinatal characteristics in NAFLD development remains poorly understood.
- Understanding these early associations is crucial for preventative strategies.
Purpose of the Study:
- To investigate the association between perinatal characteristics and the risk of developing nonalcoholic fatty liver disease in childhood.
- To identify specific maternal and neonatal factors that may predispose children to NAFLD.
- To provide evidence for early intervention in high-risk pregnancies.
Main Methods:
- A nested case-control study was conducted using data from 5104 children born in Quebec, Canada (2006-2019).
- Exposures included maternal diabetes (gestational and pre-existing), maternal obesity, prematurity, and birth complications.
- Nonalcoholic fatty liver disease diagnosis before age 14 served as the primary outcome, with adjusted odds ratios calculated.
Main Results:
- Maternal pre-existing diabetes (OR 5.75), gestational diabetes (OR 2.17), and maternal obesity (OR 3.06) were significantly associated with childhood NAFLD.
- Prematurity (OR 1.93) and neonatal intensive care unit admission (OR 2.18) also showed a positive association with NAFLD.
- No significant associations were found for low birthweight, small-for-gestational age, or macrosomia.
Conclusions:
- Maternal metabolic conditions, including diabetes and obesity, are significant risk factors for pediatric nonalcoholic fatty liver disease.
- Prematurity and neonatal complications may also contribute to the early development of NAFLD.
- These findings highlight the importance of maternal health during pregnancy for preventing childhood liver disease.
Background:
Research is beginning to implicate early life characteristics in the development of pediatric nonalcoholic fatty liver disease, however the relationship with perinatal characteristics is poorly understood.
Aims:
We evaluated the association between perinatal characteristics and nonalcoholic fatty liver disease in childhood.
Study Design:
Nested case-control study.
Subjects:
5104 children born in Quebec, Canada between 2006 and 2019. Exposures included maternal diabetes, obesity, prematurity, and other birth complications.
Outcome Measures:
The outcome was nonalcoholic fatty liver disease diagnosed in hospital before 14 years of age. We calculated adjusted odds ratios (OR) and 95% confidence intervals (CI) for the association between birth characteristics and nonalcoholic fatty liver disease.
Results:
A total of 104 children with nonalcoholic fatty liver disease were included. Gestational diabetes (OR 2.17, 95% CI 1.15-4.10), preexisting diabetes (OR 5.75, 95% CI 2.67-12.4), and maternal obesity (OR 3.06, 95% CI 1.71-5.45) were associated with childhood nonalcoholic fatty liver disease. Prematurity (OR 1.93, 95% CI 1.06-3.54) and neonatal intensive care unit admission (OR 2.18, 95% CI 1.10-4.33) were also associated with nonalcoholic fatty liver disease. However, there was no association with low birthweight, small-for-gestational age birth, and macrosomia.
Conclusions:
Maternal metabolic disorders and prematurity may initiate processes early in life that lead to the development of nonalcoholic fatty liver disease in childhood.
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