Non-Alcoholic Fatty Liver Disease in Pregnancy Outcomes

Non-Alcoholic Fatty Liver Disease (NAFLD) affects up to one in five women of reproductive age and is increasingly recognised as a contributor to adverse maternal and fetal outcomes. Characterised by excess lipid accumulation within hepatocytes in the absence of significant alcohol intake, NAFLD in pregnancy is associated with gestational diabetes mellitus, hypertensive disorders such as preeclampsia, preterm delivery and altered fetal growth patterns. Early identification of steatosis and assessment of fibrosis stage inform risk stratification, guiding multidisciplinary management involving obstetricians, hepatologists and nutrition specialists. Optimisation of metabolic health before conception, targeted surveillance of liver function and adjunctive measures—such as low-dose aspirin to mitigate preeclampsia risk—have emerged as practical interventions. Moreover, maternal steatosis has implications for long-term metabolic health in both parent and child, underscoring the importance of integrated care pathways that extend into the postpartum and lactation periods. Despite growing evidence, standardised screening protocols and safe pharmacological therapies during pregnancy remain areas of active investigation.

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Non-Alcoholic Fatty Liver Disease in Pregnancy Outcomes publication trend

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Technical terms

Hepatic steatosis: Accumulation of fat droplets within liver cells, the hallmark of NAFLD.

Fibrosis assessment: Evaluation of connective tissue deposition in the liver, indicating progression toward cirrhosis.

Atherogenic index of plasma (AIP): Logarithmic ratio of triglycerides to HDL cholesterol, used as a surrogate marker of lipid-related risk.

Gestational diabetes mellitus (GDM): Glucose intolerance first recognised during pregnancy, associated with maternal and neonatal complications.

Preeclampsia: Hypertensive disorder of pregnancy with multi-organ involvement, often linked to endothelial dysfunction and placental insufficiency.

Large-for-gestational-age (LGA): Birthweight above the 90th percentile for gestational age, often related to maternal hyperglycaemia and overnutrition.

References

1. Metabolic dysfunction–associated steatotic liver disease and pregnancy. Journal of Clinical Investigation (2025).
2. Association between the atherogenic index of plasma and non-alcoholic fatty liver disease in Korean pregnant women: secondary analysis of a prospective cohort study. Frontiers in Nutrition (2025).
3. Non-alcoholic fatty liver disease (NAFLD): a significant predictor of gestational diabetes mellitus (GDM) and early pregnancy miscarriages—prospective study in Rajarata Pregnancy Cohort (RaPCo). BMJ Open Gastroenterology (2022).