Non-alcoholic fatty liver disease (NAFLD) is now the commonest liver pathology in the UK; however, relatively little is known about its course in pregnancy or the effect it has on maternal or fetal outcomes. Described here is a 24-year-old woman in her first pregnancy who presented with non-specific symptoms and raised alanine aminotransferase with ultrasonography of her liver showing changes of steatosis and suspicious for cirrhosis, leading to a diagnosis of NAFLD. The case illustrates the need for the clinician to have awareness of this increasingly prevalent condition and for multidisciplinary management.
DysonJKAnsteeQMMcPhersonS.Non-alcoholic fatty liver disease: a practical approach to diagnosis and staging. Frontline Gastroenterol2014;
5: 211–218.
2.
HagströmHHöijerJLudvigssonJF, et al.
Adverse outcomes of pregnancy in women with non-alcoholic fatty liver disease. Liver Int2016;
36: 268–274.
3.
MousaNAbdel-RazikAShamsM, et al.
Impact of non-alcoholic fatty liver disease on pregnancy. Br J Biomed Sci2018;
75: 197–199.
4.
SukKYChangHLSangHC, et al.
Prediction of liver cirrhosis, using diagnostic imaging tools. World J Hepatol2015;
7: 2069–2079.
5.
GlenJFlorosLDayC, et al.
Non-alcoholic fatty liver disease (NAFLD): summary of NICE guidance. BMJ2016;
354: i4428.
6.
MarjotTMoollaACobboldJF, et al.
Nonalcoholic fatty liver disease in adults: current concepts in etiology, outcomes, and management. Endocr Rev2020;
41: P66–P117.
7.
EslamMArunSGeorgeJ, International Consensus Panel.
MAFLD: a consensus-driven proposed nomenclature for metabolic associated fatty liver disease. Gastroenterology2020;
158: 1999–2014.e1.
8.
ByrneCDPatelJScorlettiE, et al.
Tests for diagnosing and monitoring non-alcoholic fatty liver disease in adults. BMJ2018;
362: k2734.
CheneyKFarberRBarrattAL, et al.
Population attributable fractions of perinatal outcomes for nulliparous women associated with overweight and obesity from 1990–2014. Med J Aust2018;
208: 119–125.
11.
CastracaneVDavidGMartinezB, et al. Nonalcoholic fatty liver disease in pregnant women. In: 15thInternational and 14th European congress of endocrinology,
Florence, Italy, 5–9 May 2012, Endocrine Abstracts paper no. 29, P.938.
12.
ColliAFraquelliMAndreolettiM, et al.
Severe liver fibrosis or cirrhosis: accuracy of US for detection–analysis of 300 cases. Radiology2003;
227: 89–94.
13.
PageLGirlingJ.A novel cause for abnormal liver function tests in pregnancy and the puerperium: non‐alcoholic fatty liver disease. BJOG2011;
118: 1532–1535.
14.
ChoudharyNSSarafNSaigalS, et al.
Rapid reversal of liver steatosis with life style modification in highly motivated liver donors. J Clin Exp Hepatol2015;
5: 123–126.
15.
TanJSurtiBSaabS.Pregnancy and cirrhosis. Liver Transpl2008;
14: 1081–1091.
16.
StrebaLAVereCCRogoveanuI, et al.
Nonalcoholic fatty liver disease, metabolic risk factors, and hepatocellular carcinoma: an open question. World J Gastroenterol2015;
21: 4103–4110.
17.
WeissJLMaloneFDEmigD, et al., FASTER Research Consortium.
Obesity, obstetric complications and cesarean delivery rate–a population-based screening study. Am J Obstet Gynecol2004;
190: 1091–1097.
18.
Calzadilla BertotLAdamsLA.The natural course of non-alcoholic fatty liver disease. Int J Mol Sci2016;
17: 774.
MoollaAMotohashiKMarjotT, et al.
A multidisciplinary approach to the management of NAFLD is associated with improvement in markers of liver and cardio-metabolic health. Frontline Gastroenterol2019;
10: 337–346.
21.
HassanKBhallaVEl RegalME, et al.
Nonalcoholic fatty liver disease: a comprehensive review of a growing epidemic. World J Gastroenterol2014;
20: 12082–12101.
22.
SchummersLHutcheonJABodnarLM, et al.
Risk of adverse pregnancy outcomes by prepregnancy body mass index: a population-based study to inform prepregnancy weight loss counseling. Obstet Gynecol2015;
125: 133–143.
