New Delhi: Preterm birth risk may not just lie in weight but in the liver itself, new research reveals.
A new study from Karolinska Institutet has found that pregnant women with metabolic dysfunction-associated steatotic liver disease (MASLD) are at significantly higher risk of preterm birth, and that this increased risk cannot be explained by obesity alone.
The findings, published in the peer-reviewed journal eClinicalMedicine, highlight a pressing public health concern, as MASLD, formerly known as non-alcoholic fatty liver disease (NAFLD) is estimated to affect up to 30 percent of people globally. Commonly associated with metabolic disorders such as type 2 diabetes and obesity, MASLD has become increasingly prevalent, particularly among women of reproductive age.
In this population-based study, researchers examined Swedish national registry data comprising 240 births among women with MASLD and 1,140 matched births from the general population. Their analysis showed that women with MASLD were more than three times as likely to deliver prematurely compared to women without the condition.
“The risk did not increase with MASLD severity and the increase in risk persisted even when compared to overweight or obese women without known MASLD,” said Carole A. Marxer, lead author and postdoctoral researcher at the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet. “This suggests that the association is not only due to a high body mass index (BMI) and that the liver disease itself can have negative effects.”
The study also reported a 63 percent higher rate of caesarean delivery among women with MASLD compared to the general population. However, this particular risk appears to be driven primarily by elevated BMI, as no increased caesarean risk was observed when comparing women with MASLD to obese or overweight women without the condition.
“It is important that pregnant women with MASLD are closely monitored during pregnancy to reduce the risk of complications. Consideration should also be given to adding specific recommendations for pregnant women to the clinical guidelines for MASLD,” Marxer added.
Importantly, the study found no evidence of elevated risk for congenital malformations or neonatal death among babies born to mothers with MASLD.
“It is also worth noting that we did not find any increased risk in women with MASLD of having children with congenital malformations or of having children who died at birth,” said co-author Jonas F. Ludvigsson, paediatrician at Orebro University Hospital and professor at the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet.
While the research strengthens the understanding of MASLD’s impact on pregnancy outcomes, the authors acknowledged that other factors may also have contributed to the elevated risk.
The study underscores the need for heightened awareness and clinical attention to MASLD among expectant mothers, particularly as rates of metabolic diseases continue to rise globally.
