Non-alcoholic Fatty Liver Disease – a major predictor of GDM and early pregnancy miscarriage
NAFLD has been widely known as a major risk factor for the development of GDM and miscarriages. Still the data to confirm this association is lacking. Hence, Iresha Koralegedara and colleagues conducted a study under the title “Non-alcoholic Fatty Liver Disease (NAFLD) is a major predictor of gestational diabetes mellitus (GDM) and early pregnancy miscarriage” published in The Lancet journal. The summary of this study is mentioned below:
Objective:
To investigate the association between NAFLD vs. GDM and miscarriages.
Method:
Pregnant mothers registered in the national pregnancy care program of Anuradhapura, Sri Lanka are recruited. Ultrasound scans (USSs), Clinical and biochemical parameters were performed during the first trimester. Hyperglycemic mothers were excluded from the follow-up, and an oral glucose tolerance test(OGTT) was conducted between POA 24-28 weeks. GDM was defined as per 2016 WHO criteria.
Findings:
The study found the bidirectional relationship between NAFLD and GDM I.e. diagnosis of NAFLD at first trimester increases the risk of GDM, also there is a chance of GDM causing postpartum development of NAFLD. Additionally, the fluctuation of lipid levels, estrogen levels, and rapid weight gain play an important role in the development of NAFLD during pregnancy. Investigators highlight that the unusual occurrence of fatty liver can be a major risk factor for mid-pregnancy miscarriages.
Limitation:
Investigators suggest studies with a larger sample sizes and better diagnosis methods in the future.
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