Metabolic associated fatty liver disease and adverse maternal and fetal outcomes: a systematic review and meta-analysis

Aim of the study
Metabolic-associated fatty liver disease (MAFLD) is now the most prevalent chronic liver disease in the world. Its prevalence in women of reproductive age is approximately 10%. Due to its high prevalence in this specific population, it is important to investigate adverse maternal and fetal outcomes caused by MAFLD during pregnancy. We aimed to summarize the association between MAFLD and adverse maternal and fetal outcomes.

Material and methods
A search was conducted on PubMed and ProQuest from inception to April 1, 2021, for studies assessing the association between MAFLD and adverse maternal and fetal outcomes. The quality of included studies was assessed using the Newcastle-Ottawa scale (NOS). We analyzed the pooled odds ratios (ORs) with 95% confidence intervals (CIs) using a fixed and random-effects model. Heterogeneity was assessed using I².

Results
Six studies comprising 20,535,994 (5,964 MAFLD) pregnant women were included. The quality of studies ranged from 6 to 8 stars. MAFLD was significantly associated with increased risk of dysglycemia (OR = 3.65, 95% CI = 2.47-5.39), pregnancy-associated hypertension (OR = 3.27, 95% CI = 2.75-3.88), cesarean section (OR = 2.78, 95% CI = 1.60-4.83), and preterm birth (OR = 1.70, 95% CI = 1.37-2.10) but not large for gestational age (OR = 1.69, 95% CI = 0.64-4.45).

Conclusions
The presence of MAFLD is associated with adverse maternal and fetal outcomes.