Metabolic Dysfunction–Associated Steatotic Liver Disease in Pregnancy

Résumé fourni par la source

ABSTRACT Importance Metabolic dysfunction–associated steatotic liver disease (MASLD), formerly nonalcoholic fatty liver disease, is the most common liver condition in the United States and the leading cause of cirrhosis. MASLD is closely associated with cardiovascular diseases and shares risk factors such as obesity, hypertension, and insulin resistance. Commonly seen in pregnant women, MASLD has an estimated prevalence of 10% worldwide. Objective For many women of childbearing age, pregnancy may be the only link to medical care, presenting a critical opportunity to diagnose MASLD. It is paramount to raise awareness among obstetrician-gynecologists of the risk factors and pregnancy-related complications arising from MASLD development. Evidence Acquisition Data were obtained from a review of liver and obstetric and gynecological clinical practice guidelines. Relevant keyword searches encompassing MASLD and pregnancy in PubMed were conducted to survey literature in the English language. Results MASLD is independently associated with obstetric complications and adverse outcomes for both mother and fetus. Maternal complications include gestational diabetes mellitus, gestational hypertension, and preeclampsia, whereas fetal complications include preterm birth and large-for-gestational-age infants. Multiple studies demonstrate that dietary and exercise-related interventions to curb gestational weight gain, coupled with behavioral therapy, significantly reduce adverse maternal and neonatal outcomes. Conclusions and Relevance The presence of predisposing risk factors in the pregnant patient should prompt screening for MASLD. If MASLD is diagnosed, interventions to mitigate pregnancy-related complications are indicated. Ultimately, referral of the pregnant patient with MASLD for risk stratification and management is suggested to avoid future liver or cardiovascular-related morbidity. Target Audience Obstetricians and gynecologists, family physicians. Learning Objectives After completing this activity, the learner will be better able to discuss the prevalence and risk factors associated with MASLD in pregnancy, including metabolic syndrome, obesity, and gestational diabetes; describe the maternal and fetal complications of MASLD in pregnancy, such as gestational hypertension, preeclampsia, and large-for-gestational-age infants; and identify appropriate screening and management strategies for MASLD during pregnancy, including ultrasound diagnosis, dietary interventions, and postpartum risk stratification.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.