Clinical significance of maternal non-alcoholic fatty liver disease on childhood obesity

Non-alcoholic fatty liver disease (NAFLD) is the most prevalent chronic liver disease closely related to impaired glucose homeostasis. Therefore, many studies have been conducted to interrogate the interplay between maternal hepatic manifestation of metabolic imbalance and perinatal outcomes. For instance, we have previously demonstrated that NAFLD might be a risk factor for adverse effects during fetal development such as excessive fetal birthweight. Thus, the objective of the study is to determine the association of maternal NAFLD with childhood obesity. We conducted a large observational study in women and their offspring including 418,223 women without NAFLD and 15,302 women with NAFLD. The participants were further divided into four subgroups according to the presence or absence of gestational diabetes mellitus (GDM) during pregnancy. NAFLD was defined based on the elevated fatty liver index. The population, who gave birth between 2011 and 2020, were reviewed and the childhood weights of offspring were measured up to 7 years after birth. The children born from the women diagnosed with NAFLD had a greater chance of developing obesity, regardless of the presence of GDM. The odds ratio (OR) in the subgroup without GDM was 2.305 (p < 0.001) and the OR in the subgroup with GDM was 2.924 (p < 0.001). Furthermore, the association between maternal NAFLD and offspring obesity remained statistically significant even after adjustment for potential covariates (adjusted hazard ratio (aHR), 2.281 (95% CI 1.894-2.748) and 2.846 (95% CI 1.904-4.256) respectively). The presence of NAFLD in women prior to conception may contribute to the childhood obesity after birth.