Maternal gestational hypertension, smoking and pre-eclampsia are associated with metabolic dysfunction-associated fatty liver disease in overweight offspring

Hanna de Ruyter; Linnea Aitokari; Siiri Lahti; Hanna Riekki; Heini Huhtala; Timo Lakka; Hannele Laivuori; Kalle Kurppa

doi:10.1111/aogs.14816

Maternal gestational hypertension, smoking and pre-eclampsia are associated with metabolic dysfunction-associated fatty liver disease in overweight offspring

Acta Obstet Gynecol Scand. 2024 Mar 3. doi: 10.1111/aogs.14816. Online ahead of print.

Authors

Hanna de Ruyter¹, Linnea Aitokari^{1

2}, Siiri Lahti¹, Hanna Riekki¹, Heini Huhtala³, Timo Lakka^{4

5

6}, Hannele Laivuori^{1

7}, Kalle Kurppa^{1

2

8}

Affiliations

¹ Tampere Center for Child, Adolescent and Maternal Health Research, Tampere University and Tampere University Hospital, Wellbeing Services County of Pirkanmaa, Tampere, Finland.
² Celiac Disease Research Center, Tampere University, Tampere, Finland.
³ Faculty of Social Sciences, Tampere University, Tampere, Finland.
⁴ Institute of Biomedicine, University of Eastern Finland, Kuopio, Finland.
⁵ Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland.
⁶ Kuopio Research Institute of Exercise Medicine, Kuopio, Finland.
⁷ Medical and Clinical Genetics, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
⁸ University Consortium of Seinäjoki, Seinäjoki, Finland.

PMID: 38433535
DOI: 10.1111/aogs.14816

Abstract

Introduction: Due to a steep increase in obesity, metabolic dysfunction-associated fatty liver disease (MAFLD) has also become the most common chronic hepatic condition among children and adolescents. Various maternal and pregnancy-related factors have also been implicated in the development of MAFLD, but human studies remain scarce.

Material and methods: Comprehensive data of 460 overweight or obese children aged 2-16 years were collected and combined with data on selected maternal and pregnancy-related factors for a case-control study. MALFD was defined as alanine aminotransferase >2× upper limit of normal. Children with and without MAFLD were compared regarding to the study variables and multivariable regression analysis was utilized.

Results: Median age of the study children was 11.8 (quartiles 9.1-14.2) years; 44% were girls and 17.8% had MAFLD. Children with MAFLD were older (12.7 vs. 11.6 years, p = 0.002), while the groups did not differ age-standardized body mass index (BMI-SDS) or gender. Factors associated with MAFLD in a multivariable model considering also the offspring's present BMI-SDS, sex, and maternal prepregnancy overweight, were child's older age (odds ratio [OR] 1.16, 95% confidence interval [CI]: 1.06-1.28), maternal gestational smoking (OR 2.01, 95% CI: 1.16-3.47), gestational hypertension (OR 3.44, 95% CI: 1.08-11.0) and pre-eclampsia (OR 2.93, 95% CI: 1.15-7.45). There was no significant association between MAFLD and maternal BMI, birth anthropometrics or perinatal complications.

Conclusions: Maternal smoking, gestational hypertension and pre-eclampsia were associated with MAFLD among overweight or obese children. Further prospective studies are needed to verify causal relationships.

Keywords: MAFLD; children; fatty liver; obesity; overweight; pregnancy; prenatal.

Abstract

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