Obstetric Outcomes in Women with Nonalcoholic Fatty Liver Disease

Background: Nonalcoholic fatty liver disease (NAFLD) is one of the most common chronic liver diseases in the Western world and yet there is little research into its impact on pregnancy. Methods: A literature review was conducted in the database PubMed, with articles published between 1990 and 2017. The selected studies addressed features specifically attributed to NAFLD and associated obstetric and neonatal outcomes. Nine studies met criteria. Our aim was to consolidate the limited literature and identify trends. Results: There was considerable heterogeneity in the diagnostic approach to NAFLD. Data are conflicting as to whether NAFLD increases the risk of gestational diabetes independent of obesity. NAFLD is associated with an elevated risk of extremes of birth weight, both small and large for gestational age. Several studies found a greater impact of NAFLD on maternal morbidity including preeclampsia in women with a body mass index <30kg/m(2). Conclusions: NAFLD appears to be associated with increased obstetric morbidity, particularly among non-obese women. More research is needed to clarify the pathophysiology and optimize safe treatment.