1,192
Views
10
CrossRef citations to date
0
Altmetric
Review

Fatty liver in pregnancy: a narrative review of two distinct conditions

, , , &
Pages 127-135 | Received 03 Oct 2019, Accepted 09 Jan 2020, Published online: 20 Jan 2020

References

  • Marchesini G, Brizi M, Bianchi G, et al. Nonalcoholic fatty liver disease: a feature of the metabolic syndrome. Diabetes. 2001;50:1844–1850.
  • Abenavoli L, Milic N, Di Renzo L, et al. Metabolic aspects of adult patients with nonalcoholic fatty liver disease. World J Gastroenterol. 2016;22:7006–7016.
  • Taylor R. Pathogenesis of type 2 diabetes: tracing the reverse route from cure to cause. Diabetologia. 2008;51:1781–1789.
  • Mazzotti A, Caletti MT, Sasdelli AS, et al. Pathophysiology of nonalcoholic fatty liver disease: lifestyle-gut-gene interaction. Dig Dis. 2016;34(Suppl 1):3–10.
  • Yki-Jarvinen H. Non-alcoholic fatty liver disease as a cause and a consequence of metabolic syndrome. Lancet Diabetes Endocrinol. 2014;2:901–910.
  • Younossi ZM, Koenig AB, Abdelatif D, et al. Global epidemiology of nonalcoholic fatty liver disease-meta-analytic assessment of prevalence, incidence, and outcomes. Hepatology. 2016;64:73–84.
  • Ratziu V, Marchesini G. When the journey from obesity to cirrhosis takes an early start. J Hepatol. 2016;65:249–251.
  • Wieland A, Frank DN, Harnke B, et al. Systematic review: microbial dysbiosis and nonalcoholic fatty liver disease. Aliment Pharmacol Ther. 2015;42:1051–1063.
  • European Association for the Study of the Liver, European Association for the Study of Diabetes, European Association for the Study of Obesity. EASL-EASD-EASO clinical practice guidelines for the management of non-alcoholic fatty liver disease. J Hepatol. 2016;64:1388–1402.
  • Younossi Z, Anstee QM, Marietti M, et al. Global burden of NAFLD and NASH: trends, predictions, risk factors and prevention. Nat Rev Gastroenterol Hepatol. 2018;15:11–20.
  • Pimpin L, Cortez-Pinto H, Negro F, et al. Burden of liver disease in Europe: epidemiology and analysis of risk factors to identify prevention policies. J Hepatol. 2018;69:718–735.
  • Estes C, Anstee QM, Arias-Loste MT, et al. Modeling NAFLD disease burden in China, France, Germany, Italy, Japan, Spain, United Kingdom, and United States for the period 2016–2030. J Hepatol. 2018;69:896–904.
  • Younossi ZM, Blissett D, Blissett R, et al. The economic and clinical burden of nonalcoholic fatty liver disease in the United States and Europe. Hepatology. 2016;64:1577–1586.
  • Italian Association for the Study of the Liver. AISF position paper on liver disease and pregnancy. Dig Liver Dis. 2016;48:120–137.
  • Younossi ZM, Golabi P, de Avila L, et al. The global epidemiology of NAFLD and NASH in patients with type 2 diabetes: a systematic review and meta-analysis. J Hepatol. 2019;71:793–801.
  • Westbrook RH, Dusheiko G, Williamson C. Pregnancy and liver disease. J Hepatol. 2016;64:933–945.
  • Garcia-Romero CS, Guzman C, Cervantes A, et al. Liver disease in pregnancy: medical aspects and their implications for mother and child. Ann Hepatol. 2019;18:553–562.
  • Bedogni G, Bellentani S, Miglioli L, et al. The fatty liver index: a simple and accurate predictor of hepatic steatosis in the general population. BMC Gastroenterol. 2006;6:33.
  • Alese MO, Moodley J, Naicker T. Preeclampsia and HELLP syndrome, the role of the liver. J Matern Fetal Neonatal Med. 2019 Jan 31. (Epub ahead of print). DOI: 10.1080/14767058.2019.1572737.
  • Vallet-Pichard A, Mallet V, Nalpas B, et al. FIB-4: an inexpensive and accurate marker of fibrosis in HCV infection. comparison with liver biopsy and fibrotest. Hepatology. 2007;46:32–36.
  • Angulo P, Hui JM, Marchesini G, et al. The NAFLD fibrosis score: a noninvasive system that identifies liver fibrosis in patients with NAFLD. Hepatology. 2007;45:846–854.
  • Guha IN, Parkes J, Roderick P, et al. Noninvasive markers of fibrosis in nonalcoholic fatty liver disease: validating the European liver fibrosis panel and exploring simple markers. Hepatology. 2008;47:455–460.
  • Hershman M, Mei R, Kushner T. Implications of nonalcoholic fatty liver disease on pregnancy and maternal and child outcomes. Gastroenterol Hepatol (NY). 2019;15:221–228.
  • De Souza LR, Berger H, Retnakaran R, et al. Non-alcoholic fatty liver disease in early pregnancy predicts dysglycemia in mid-pregnancy: prospective study. Am J Gastroenterol. 2016;111:665–670.
  • Hagstrom H, Hoijer J, Ludvigsson JF, et al. Adverse outcomes of pregnancy in women with non-alcoholic fatty liver disease. Liver Int. 2016;36:268–274.
  • Yarrington CD, Cantonwine DE, Seely EW, et al. The association of alanine aminotransferase in early pregnancy with gestational diabetes. Metab Syndr Relat Disord. 2016;14:254–258.
  • Lee SM, Kwak SH, Koo JN, et al. Non-alcoholic fatty liver disease in the first trimester and subsequent development of gestational diabetes mellitus. Diabetologia. 2019;62:238–248.
  • Barker DJ. The developmental origins of adult disease. J Am Coll Nutr. 2004;23:588S–95S.
  • Wesolowski SR, Kasmi KC, Jonscher KR, et al. Developmental origins of NAFLD: a womb with a clue. Nat Rev Gastroenterol Hepatol. 2017;14:81–96.
  • Nobili V, Marcellini M, Marchesini G, et al. Intrauterine growth retardation, insulin resistance, and nonalcoholic fatty liver disease in children. Diabetes Care. 2007;30:2638–2640.
  • Bruce KD, Jonscher KR. Assessment of fatty liver in models of disease programming. Methods Mol Biol. 2018;1735:251–266.
  • Chalasani N, Younossi Z, Lavine JE, et al. The diagnosis and management of nonalcoholic fatty liver disease: practice guidance from the American association for the study of liver diseases. Hepatology. 2018;67:328–357.
  • Vilar-Gomez E, Martinez-Perez Y, Calzadilla-Bertot L, et al. Weight loss through lifestyle modification significantly reduces features of nonalcoholic steatohepatitis. Gastroenterology. 2015;149:367–78e5; quiz e14-5.
  • Wong VW, Wong GL, Chan RS, et al. Beneficial effects of lifestyle intervention in non-obese patients with non-alcoholic fatty liver disease. J Hepatol. 2018;69:1349–1356.
  • Itoh H, Kanayama N. Developmental origins of nonalcoholic fatty liver disease (NAFLD). Adv Exp Med Biol. 2018;1012:29–39.
  • Sanyal AJ. Past, present and future perspectives in nonalcoholic fatty liver disease. Nat Rev Gastroenterol Hepatol. 2019;16:377–386.
  • American Diabetes Association. 14. Management of diabetes in pregnancy: standards of medical care in diabetes-2019. Diabetes Care. 2019;42:S165–S72.
  • Rowan JA, Rush EC, Plank LD, et al. Metformin in gestational diabetes: the offspring follow-up (MiG TOFU): body composition and metabolic outcomes at 7–9 years of age. BMJ Open Diabetes Res Care. 2018;6:e000456.
  • Balsells M, Garcia-Patterson A, Sola I, et al. Glibenclamide, metformin, and insulin for the treatment of gestational diabetes: a systematic review and meta-analysis. BMJ. 2015;350:h102.
  • Farrar D, Simmonds M, Bryant M, et al. Treatments for gestational diabetes: a systematic review and meta-analysis. BMJ Open. 2017;7:e015557.
  • Holt RI, Lambert KD. The use of oral hypoglycaemic agents in pregnancy. Diabet Med. 2014;31:282–291.
  • Armstrong MJ, Gaunt P, Aithal GP, et al. Liraglutide safety and efficacy in patients with non-alcoholic steatohepatitis (LEAN): a multicentre, double-blind, randomised, placebo-controlled phase 2 study. Lancet. 2016;387:679–690.
  • Liu J, Ghaziani TT, Wolf JL. Acute fatty liver disease of pregnancy: updates in pathogenesis, diagnosis, and management. Am J Gastroenterol. 2017;112:838–846.
  • Farajpour R, Ghavidel A, Farajpour S, et al. A case of acute fatty liver of second trimester of pregnancy. Hepatol Int. 2015;2015:S389–90.
  • Monga M, Katz AR. Acute fatty liver in the second trimester. Obstet Gynecol. 1999;93:811–813.
  • Buytaert IM, Elewaut GP, Van Kets HE. Early occurrence of acute fatty liver in pregnancy. Am J Gastroenterol. 1996;91:603–604.
  • de Nagy J, Strittmatter CA, Lee RV. Acute fatty liver of pregnancy presenting as hepatic encephalopathy at 28 weeks’ gestation. J Obstet Gynaecol. 2008;28:100–102.
  • Suzuki S, Watanabe S, Araki T. Acute fatty liver of pregnancy at 23 weeks of gestation. BJOG. 2001;108:223–224.
  • Fesenmeier MF, Coppage KH, Lambers DS, et al. Acute fatty liver of pregnancy in 3 tertiary care centers. Am J Obstet Gynecol. 2005;192:1416–1419.
  • Knight M, Nelson-Piercy C, Kurinczuk JJ, et al. A prospective national study of acute fatty liver of pregnancy in the UK. Gut. 2008;57:951–956.
  • Ch’ng CL, Morgan M, Hainsworth I, et al. Prospective study of liver dysfunction in pregnancy in Southwest Wales. Gut. 2002;51:876–880.
  • Nelson DB, Yost NP, Cunningham FG. Acute fatty liver of pregnancy: clinical outcomes and expected duration of recovery. Am J Obstet Gynecol. 2013;209:456 e1–7.
  • Solanke D, Rathi C, Pandey V, et al. Etiology, clinical profile, and outcome of liver disease in pregnancy with predictors of maternal mortality: a prospective study from Western India. Indian J Gastroenterol. 2016;35:450–458.
  • Castro MA, Fassett MJ, Reynolds TB, et al. Reversible peripartum liver failure: a new perspective on the diagnosis, treatment, and cause of acute fatty liver of pregnancy, based on 28 consecutive cases. Am J Obstet Gynecol. 1999;181:389–395.
  • Liu G, Shang X, Yuan B, et al. Acute fatty liver of pregnancy: analysis on the diagnosis and treatment of 15 cases. J Reprod Med. 2016;61:282–286.
  • Natarajan SK, Ibdah JA. Role of 3-hydroxy fatty acid-induced hepatic lipotoxicity in acute fatty liver of pregnancy. Int J Mol Sci. 2018;19:322.
  • Brett KE, Ferraro ZM, Yockell-Lelievre J, et al. Maternal-fetal nutrient transport in pregnancy pathologies: the role of the placenta. Int J Mol Sci. 2014;15:16153–16185.
  • Shekhawat P, Bennett MJ, Sadovsky Y, et al. Human placenta metabolizes fatty acids: implications for fetal fatty acid oxidation disorders and maternal liver diseases. Am J Physiol Endocrinol Metab. 2003;284:E1098–105.
  • Goel A, Ramakrishna B, Zachariah U, et al. How accurate are the Swansea criteria to diagnose acute fatty liver of pregnancy in predicting hepatic microvesicular steatosis? Gut. 2011;60:138–9; author reply 9–40
  • Castro MA, Ouzounian JG, Colletti PM, et al. Radiologic studies in acute fatty liver of pregnancy. A review of the literature and 19 new cases. J Reprod Med. 1996;41:839–843.
  • Wei Q, Zhang L, Liu X. Clinical diagnosis and treatment of acute fatty liver of pregnancy: a literature review and 11 new cases. J Obstet Gynaecol Res. 2010;36:751–756.
  • Cheng N, Xiang T, Wu X, et al. Acute fatty liver of pregnancy: a retrospective study of 32 cases in South China. J Matern Fetal Neonatal Med. 2014;27:1693–1697.
  • Goodacre RL, Hunter DJ, Millward S, et al. The diagnosis of acute fatty liver of pregnancy by computed tomography. J Clin Gastroenterol. 1988;10:680–682.
  • Usta IM, Barton JR, Amon EA, et al. Acute fatty liver of pregnancy: an experience in the diagnosis and management of fourteen cases. Am J Obstet Gynecol. 1994;171:1342–1347.
  • Chatel P, Ronot M, Roux O, et al. Transient excess of liver fat detected by magnetic resonance imaging in women with acute fatty liver of pregnancy. Am J Obstet Gynecol. 2016;214:127–129.
  • Duvekot J, Verveer C, Neven L, et al. Transient elastography (TE) of the liver as a new diagnostic tool to discriminate between HELLP syndrome and acute fatty liver of pregnancy (AFLP)? Pregnancy Hypertens. 2015;5:2–3.
  • Kushner T, Sarkar M, Tran T. Noninvasive tests for prognosticating outcomes in patients with chronic liver disease in pregnancy: ready for prime time? Am J Gastroenterol. 2019;114:209–211.
  • Jayawardena L, McNamara E. Diagnosis and management of pregnancies complicated by Haemolysis, Elevated Liver Enzymes and Low Platelets (HELLP) syndrome in the tertiary setting. Intern Med J. 2019 May 6. (Epub ahead of print). DOI: 10.1111/imj.14337.
  • Vigil-De Gracia P. Acute fatty liver and HELLP syndrome: two distinct pregnancy disorders. Int J Gynaecol Obstet. 2001;73:215–220.
  • Haram K, Svendsen E, Abildgaard U. The HELLP syndrome: clinical issues and management. A review. BMC Pregnancy Childbirth. 2009;9:8.
  • Minakami H, Morikawa M, Yamada T, et al. Differentiation of acute fatty liver of pregnancy from syndrome of hemolysis, elevated liver enzymes and low platelet counts. J Obstet Gynaecol Res. 2014;40:641–649.
  • Morton A. Acute fatty liver of pregnancy-differential diagnosis. Am J Gastroenterol. 2017;112:1342.
  • Hay JE. Liver disease in pregnancy. Hepatology. 2008;47:1067–1076.
  • Wu Z, Huang P, Gong Y, et al. Treating acute fatty liver of pregnancy with artificial liver support therapy: systematic review. Medicine (Baltimore). 2018;97:e12473.
  • Kushner T, Tholey D, Dodge J, et al. Outcomes of liver transplantation for acute fatty liver disease of pregnancy. Am J Transplant. 2019;19:2101–2107.
  • Li P, Lin S, Li L, et al. Utility of MELD scoring system for assessing the prognosis of acute fatty liver of pregnancy. Eur J Obstet Gynecol Reprod Biol. 2019;240:161–166.
  • Yang Y, Deng L, Li X, et al. Evaluation of the prognosis of fulminant viral hepatitis in late pregnancy by the MELD scoring system. Eur J Clin Microbiol Infect Dis. 2012;31:2673–2678.
  • Murali AR, Devarbhavi H, Venkatachala PR, et al. Factors that predict 1-month mortality in patients with pregnancy-specific liver disease. Clin Gastroenterol Hepatol. 2014;12:109–113.
  • Wei Y, Xu Q, Yang H, et al. Preconception diabetes mellitus and adverse pregnancy outcomes in over 6.4 million women: a population-based cohort study in China. PLoS Med. 2019;16:e1002926.
  • Gonsalkorala ES, Cannon MD, Lim TY, et al. Non-invasive markers (ALBI and APRI) predict pregnancy outcomes in women with chronic liver disease. Am J Gastroenterol. 2019;114:267–275.
  • Hadem J, Stiefel P, Bahr MJ, et al. Prognostic implications of lactate, bilirubin, and etiology in German patients with acute liver failure. Clin Gastroenterol Hepatol. 2008;6:339–345.
  • Westbrook RH, Yeoman AD, Joshi D, et al. Outcomes of severe pregnancy-related liver disease: refining the role of transplantation. Am J Transplant. 2010;10:2520–2526.
  • Cetin O, Karaman E, Arslan H, et al. Evaluation of maternal liver elasticity by acoustic radiation force impulse elastosonography in hypertensive disorders of pregnancy: a preliminary descriptive study. J Matern Fetal Neonatal Med. 2017;30:2281–2286.
  • Pavlides M, Banerjee R, Tunnicliffe EM, et al. Multiparametric magnetic resonance imaging for the assessment of non-alcoholic fatty liver disease severity. Liver Int. 2017;37:1065–1073.
  • Wilman HR, Kelly M, McDonald N, et al. Non-invasive multiparametric MRI (LiverMultiScanTM) effectively excludes NASH and liver fibrosis in at risk patients. J Hepatol. 2017;66:S242.

Reprints and Corporate Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

To request a reprint or corporate permissions for this article, please click on the relevant link below:

Academic Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

Obtain permissions instantly via Rightslink by clicking on the button below:

If you are unable to obtain permissions via Rightslink, please complete and submit this Permissions form. For more information, please visit our Permissions help page.