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Adverse outcomes of pregnancy in women with non‐alcoholic fatty liver disease
Author(s) -
Hagström Hannes,
Höijer Jonas,
Ludvigsson Jonas F.,
Bottai Matteo,
Ekbom Anders,
Hultcrantz Rolf,
Stephansson Olof,
Stokkeland Knut
Publication year - 2016
Publication title -
liver international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.873
H-Index - 110
eISSN - 1478-3231
pISSN - 1478-3223
DOI - 10.1111/liv.12902
Subject(s) - medicine , obstetrics , gestational diabetes , pregnancy , fatty liver , relative risk , polycystic ovary , caesarean section , body mass index , small for gestational age , birth weight , obesity , confidence interval , gestation , disease , insulin resistance , genetics , biology
Background & Aims Non‐alcoholic fatty liver disease ( NAFLD ) is considered the most common liver disease in the world, but little is known about its potential association with pregnancy outcomes. We aimed to investigate pregnancy outcomes in NAFLD . Methods The Swedish Medical Birth Register ( MBR ) was used to identify births between 1992 and 2011 ( N = 1 960 416). By linkage with the National Patient Register, we identified women with a diagnosis of NAFLD . The MBR was then used to identify outcomes: gestational diabetes, pre‐eclampsia, Caesarean section, Apgar score <7 at 5 min, preterm birth (<37 weeks), low birth weight (<2500 g), infants born small for gestational age and congenital malformations. As controls, we used women with no diagnosis for NAFLD divided into two groups; with and without polycystic ovary syndrome ( PCOS ). Poisson regression was used to estimate relative risks ( RR s) adjusted for maternal age, smoking status and body mass index at early pregnancy, parity and prepregnancy diabetes. Results We identified 110 pregnancies in women with NAFLD . Using women without a diagnosis of NAFLD or PCOS as controls; NAFLD was associated with gestational diabetes [adjusted RR s 2.78; 95% confidence interval ( CI ): 1.25–6.15], pre‐eclampsia ( aRR 1.95; 95% CI 1.03–3.70), Caesarean section ( aRR 1.52; 95% CI 1.19–1.94), preterm birth ( aRR 2.50; 95% CI 1.38–4.55) and with low birth weight ( aRR 2.40; 95% CI 1.21–4.78). Conclusion Women with a diagnosis of NAFLD prior to giving birth have increased risks for adverse pregnancy outcome independently of body mass index and diabetes, and should be carefully monitored during antenatal care.