Maternal obesity and metabolic (dysfunction) associated fatty liver disease in pregnancy: a comprehensive narrative review.

Emmanouil Karteris, Harpal S Randeva, Bianca M Leca, Chris Kite, Lukasz Lagojda, Ioannis Kyrou, Eva Kassi

Journal: Expert review of endocrinology & metabolism 2024;19(4):335-348

PMID: 38860684

Abstract

INTRODUCTION

Obesity and metabolic-associated fatty liver disease (MAFLD) during pregnancy constitute significant problems for routine antenatal care, with increasing prevalence globally. Similar to obesity, MAFLD is associated with a higher risk for maternal complications (e.g. pre-eclampsia and gestational diabetes) and long-term adverse health outcomes for the offspring. However, MAFLD during pregnancy is often under-recognized, with limited management/treatment options.

AREAS COVERED

PubMed/MEDLINE, EMBASE, and Scopus were searched based on a search strategy for obesity and/or MAFLD in pregnancy to identify relevant papers up to 2024. This review summarizes the pertinent evidence on the relationship between maternal obesity and MAFLD during pregnancy. Key mechanisms implicated in the underlying pathophysiology linking obesity and MAFLD during pregnancy (e.g. insulin resistance and dysregulated adipokine secretion) are highlighted. Moreover, a diagnostic approach for MAFLD diagnosis during pregnancy and its complications are presented. Finally, promising relevant areas for future research are covered.

EXPERT OPINION

Research progress regarding maternal obesity, MAFLD, and their impact on maternal and fetal/offspring health is expected to improve the relevant diagnostic methods and lead to novel treatments. Thus, routine practice could apply more personalized management strategies, incorporating individualized algorithms with genetic and/or multi-biomarker profiling to guide prevention, early diagnosis, and treatment.

Address: Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism (WISDEM), University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK.; Warwick Medical School, University of Warwick, Coventry, UK.; Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism (WISDEM), University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK.; Clinical Evidence-Based Information Service (CEBIS), University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK.; Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism (WISDEM), University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK.; School of Health and Society, Faculty of Education, Health and Wellbeing, University of Wolverhampton, Wolverhampton, UK.; Centre for Sport, Exercise and Life Sciences, Research Institute for Health & Wellbeing, Coventry University, Coventry, UK.; Chester Medical School, University of Chester, Shrewsbury, UK.; College of Health, Medicine and Life Sciences, Division of Biosciences, Brunel University London, Uxbridge, UK.; Department of Biological Chemistry, Medical School, National and Kapodistrian University of Athens, Athens, Greece.; Endocrine Unit, 1st Department of Propaedeutic Internal Medicine, Laiko Hospital, National and Kapodistrian University of Athens, Athens, Greece.; Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism (WISDEM), University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK.; Warwick Medical School, University of Warwick, Coventry, UK.; Centre for Sport, Exercise and Life Sciences, Research Institute for Health & Wellbeing, Coventry University, Coventry, UK.; Institute of Cardiometabolic Medicine, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK.; Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism (WISDEM), University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK.; Warwick Medical School, University of Warwick, Coventry, UK.; Centre for Sport, Exercise and Life Sciences, Research Institute for Health & Wellbeing, Coventry University, Coventry, UK.; Institute of Cardiometabolic Medicine, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK.; Aston Medical School, College of Health and Life Sciences, Aston University, Birmingham, UK.; College of Health, Psychology and Social Care, University of Derby, Derby, UK.; Laboratory of Dietetics and Quality of Life, Department of Food Science and Human Nutrition, School of Food and Nutritional Sciences, Agricultural University of Athens, Athens, Greece.

DOI: 10.1080/17446651.2024.2365791

Link outs

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Full Text Sources:

https://www.tandfonline.com/doi/10.1080/17446651.2...

Medical:

https://medlineplus.gov/healthproblemsinpregnancy....

MeSH Terms: Humans, Pregnancy, Female, Pregnancy Complications, Pregnancy in Obesity, Non-alcoholic Fatty Liver Disease