Metabolic Dysfunction-Associated Steatotic Liver Disease in Pregnancy

Area of Science:

• Hepatology
• Obstetrics & Gynecology
• Cardiovascular Disease

Background:

• Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most prevalent liver condition in the US, linked to cardiovascular diseases and sharing risk factors like obesity and insulin resistance.
• MASLD affects approximately 10% of the global population and is frequently observed in pregnant women.
• Pregnancy offers a unique window for medical intervention, making it crucial to recognize MASLD risk factors and complications in this demographic.

Purpose of the Study:

• To highlight the importance of raising awareness among obstetrician-gynecologists regarding MASLD.
• To emphasize the critical opportunity pregnancy presents for diagnosing MASLD.
• To inform healthcare providers about MASLD's association with pregnancy-related complications.

Main Methods:

• Review of clinical practice guidelines in liver and obstetric/gynecological fields.
• Literature search in PubMed using keywords related to MASLD and pregnancy.
• Analysis of English-language studies on MASLD in pregnant populations.

Main Results:

• MASLD is independently linked to adverse obstetric outcomes, including gestational diabetes, hypertension, and preeclampsia.
• Fetal complications associated with MASLD include preterm birth and large-for-gestational-age infants.
• Dietary, exercise, and behavioral interventions effectively reduce adverse maternal and neonatal outcomes.

Conclusions:

• Screening for MASLD is recommended in pregnant patients with predisposing risk factors.
• Interventions are crucial for mitigating MASLD-related pregnancy complications.
• Referral for risk stratification and management of MASLD in pregnancy is advised to prevent long-term liver and cardiovascular morbidity.