Adverse pregnancy and birth outcomes in women with biopsy-proven MASLD: a nationwide cohort study

作者：Carole A. Marxer, Fahim Ebrahimi, David Bergman, Jiangwei Sun, Hannes Hagström, Marcus Thuresson, Olof Stephansson, Jonas F. Ludvigsson · 发表于：EClinicalMedicine · 年份：2025 · DOI：10.1016/j.eclinm.2025.103238 · 被引用次数：9 · 研究领域：Liver Disease Diagnosis and Treatment、Gestational Diabetes Research and Management、Pregnancy and preeclampsia studies

Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) has been linked to an increased risk of adverse pregnancy outcomes. We aimed to assess the roles of obesity, familial factors, and disease severity. Methods: Nationwide cohort study in Sweden (1992-2017) including 240 births (162 women) with biopsy-proven MASLD vs. 1140 matched reference births (1138 women). Multivariable conditional logistic regression determined adjusted odds ratios (aORs) for adverse pregnancy outcomes. Findings: Preterm birth occurred in 40 (16.7%) births of women with MASLD compared to 53 (4.7%) in reference births, yielding an aOR of 3.41 (95% CI = 1.98-5.88), which remained increased when compared with overweight/obese women without known MASLD (aOR = 4.60, 95% CI = 2.00-10.60). The association was observed for both medically indicated preterm birth (aOR = 11.90, 95% CI = 2.46-57.59) and spontaneous preterm birth (aOR = 2.42, 95% CI = 1.16-5.04). The aOR of preterm birth did not increase with MASLD severity (MASH without fibrosis/noncirrhotic fibrosis/cirrhosis: aOR = 1.53, 95% CI = 0.23-10.02), but 95% CIs were wide. MASLD was linked to increased odds of cesarean section (aOR = 1.63, 95% CI = 1.17-2.27), but not when compared with overweight/obese reference women (aOR = 1.20, 95% CI = 0.77-1.86). Our results indicate comparable Apgar scores, and similar rates of congenital malformation, stillbirth and neonatal death in both groups. Main results were confirmed in sibling analy...