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KMID : 1040620220280010052
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Clinical and Molecular Hepatology
2022 Volume.28 No. 1 p.52 ~ p.66
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Systematic review with meta-analysis: Non-alcoholic fatty liver disease and the association with pregnancy outcomes
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El Jamaly Hydar
Eslick Guy D.
Weltman Martin
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Abstract
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Background/Aims: Maternal and fetal outcomes in pregnant patients with Non-alcoholic fatty liver disease (NAFLD) have been largely unexplored. To determine the level of evidence associated with maternal and fetal outcomes in pregnant women with NAFLD.
Methods: We conducted a comprehensive literature search. The studies included pregnant patients with a previous, current or subsequent diagnosis of NAFLD. We used a random-effects model using odds ratios (OR) with 95% confidence intervals (CI).
Results: Twenty-two studies, with 13,641 female NAFLD patients were reviewed. The results highlight that NAFLD patients had a statistically significant increased likelihood of baseline diabetes mellitus (OR, 6.00; 95% CI, 2.21?16.31; P<0.001; n=7), baseline Hypertension (OR, 3.75; 95% CI, 2.13?6.59; P<0.001; n=4), gestational hypertension (OR, 1.83; 95% CI, 1.03?3.26; P=0.041; n=2), and pre-eclampsia (OR, 2.43; 95% CI, 1.46?4.04; P=0.001; n=3). The odds for a past and current history of gestational diabetes mellitus were OR, 3.78; 95% CI, 2.21?6.44; P<0.001; n=5 and OR, 3.23; 95% CI, 1.97? 5.31; P<0.001; n=6, respectively. As for fetal outcomes, pregnant NAFLD patients were significantly more likely to have a premature birth (OR, 2.02; 95% CI, 1.44?2.85; P<0.001; n=4), large for gestational age birth (OR, 2.01; 95% CI, 1.72?2.37; P<0.001; n=2) or a history of prior miscarriage or abortion (OR, 1.15; 95% CI, 1.02?1.30; P=0.02; n=2). Egger’s regression revealed no evidence of publication bias (P>0.05).
Conclusions: This meta-analysis provides pooled evidence that NAFLD is associated with a substantial increase in maternal diabetic and hypertensive complications and multiple adverse fetal outcomes. This data is important for clinicians managing these patients before, during and after pregnancy.
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KEYWORD
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Non-alcoholic fatty liver disease, Diabetes mellitus, Hypertension, Obesity, Pregnancy complications
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