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Reply to ‘Pregnancy and liver health: delivering new collaborations to advance the MASLD and MASH field’

Nature Reviews Gastroenterology & Hepatology volume 22, page 596 (2025)Cite this article

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We thank Borges Manna and Ovadia for their comments on our recent Perspective (Envisioning how to advance the MASH field. Nat. Rev. Gastroenterol. Hepatol. 21, 726–738 (2024))1 and for highlighting the importance of including pregnancy as a lens through which to further the MASLD public health agenda (Pregnancy and liver health: delivering new collaborations to advance the MASLD and MASH field. Nat. Rev. Gastroenterol. Hepatol. https://doi.org/10.1038/s41575-025-01094-4 (2025))2.

Metabolic dysfunction-associated steatotic liver disease (MASLD; formerly known as nonalcoholic fatty liver disease)3 is now the leading cause of end-stage liver disease requiring liver transplantation in women4. Owing to its slow progression, early identification — potentially decades before complications arise — presents a critical opportunity for timely intervention to prevent cirrhosis, adverse outcomes and mortality. Though rare, cirrhosis in pregnancy worsens fetal outcomes5. Antenatal and postpartum periods present ideal windows for early detection.

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References

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Authors and Affiliations

  1. Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, MN, USA

    Alina M. Allen

  2. City University of New York Graduate School of Public Health & Health Policy (CUNY SPH), New York City, NY, USA

    Jeffrey V. Lazarus

  3. Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain

    Jeffrey V. Lazarus

Authors
  1. Alina M. Allen
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  2. Jeffrey V. Lazarus
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Correspondence to Jeffrey V. Lazarus.

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Competing interests

A.M.A. has received grants from the National Institutes of Health, Novo Nordisk, Pfizer, Target Pharma, Oncoustics, Escopics, Madrigal and Siemens, outside the submitted work; and consulting fees from Madrigal Pharmaceuticals, Boehringer Ingelheim, Novo Nordisk and GSK. J.V.L. received grants to his institutions from AbbVie, Boehringer Ingelheim, Echosens, Gilead Sciences, Madrigal Pharmaceuticals, Moderna, MSD, Novo Nordisk, Pfizer and Roche Diagnostics; consulting fees from Echosens, Global NASH Council, GSK, Madrigal Pharmaceuticals, Novo Nordisk and Pfizer; and honoraria for lectures from AbbVie, Echosens, Gilead Sciences, GSK, Janssen, Moderna, MSD, Novo Nordisk, Pfizer and Prosciento outside of the submitted work.

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Allen, A.M., Lazarus, J.V. Reply to ‘Pregnancy and liver health: delivering new collaborations to advance the MASLD and MASH field’. Nat Rev Gastroenterol Hepatol 22, 596 (2025). https://doi.org/10.1038/s41575-025-01095-3

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