Association Between Ultrasonographically Detected Fatty Liver and Maternal Lipid Levels and Adverse Obstetric Outcomes

Abstract

Objective: Fatty liver, which is increasingly common in pregnancy, is associated with maternal health risks. This study aimed to explore the association between ultrasound-detected fatty liver, maternal lipid levels, and adverse obstetric outcomes Method: This prospective cohort study included pregnant women who attended the Gynecology Department of University of Health Sciences Turkey, Prof. Dr. Cemil Taşcıoğlu City Hospital between 24 and 42 weeks of gestation for their antenatal visit. The study period was from February 1, 2020, to December 31, 2020. Results: The 232 participants were divided into two groups based on ultrasound findings: Group 1 (n=121) with grade 0-1 fatty liver, and Group 2 (n=111) with grade 2-3 fatty liver. Statistically significant increases in maternal age, pregestational body mass index (BMI), and fetal weight were observed among women diagnosed with fatty liver on ultrasound. Regarding BMI, a cut-off value of ≥27.2 kg/m2 exhibited a sensitivity of 58.6%, specificity of 66.12%, positive predictive value (PPV) of 61.30%, negative predictive value (NPV) of 63.50%, and LR(+) of 1.73%. Similarly, for triglycerides, a cut-off value of ≥240 mg/dL showed sensitivity of 62.16%, specificity of 87.60%, PPV of 82.10%, NPV of 71.60%, and LR(+) of 5.01%. Multivariate logistic regression analysis revealed a decreased risk of small for gestational age [0.98 (0.96-1.00) odds ratio (OR) 95% confidence interval (CI); p=0.016)] and an increased risk of gestational diabetes mellitus [0.98 (0.96-0.99) OR 95% CI; p=0.045)]. Conclusion: Fatty liver in pregnancy is associated with an increased risk of gestational diabetes mellitus (GDM), but not with other adverse obstetric outcomes.

Keywords

• adverse obstetric outcome
• fatty liver
• pregnancy
• maternal lipid levels