Nonalcoholic steatohepatitis and obesity: influence of key risk factors on the development of obstetric and perinatal complications in pregnant women

Abstract

The aim of our study is to assess the development of obstetric and perinatal complications in obese pregnant women with non-alcoholic steatohepatitis (NASH) depending on changes in blood lipid spectrum and body mass index (BMI). Materials and methods. We examined 98 pregnant women with non-alcoholic fatty liver disease (NAFLD) at the stage of NASH in combination with obesity. The control group consisted of 30 healthy pregnant women. All pregnant women with NAFLD and abdominal obesity were divided into 3 groups depending on BMI: Group I – 26 pregnant women with BMI 25.0–29.9 kg/m², Group II – 48 pregnant women with BMI 30.0–34.9 kg/m2, Group III – 24 pregnant women with BMI 35.0–39.9 kg/m2. Correlations of obstetric complications depending on changes in lipid metabolism and BMI were determined. Results. The analysis of obstetric complications revealed 3.4 times higher risk of early miscarriage in group I, 5.6 times – in group II, 7.5 times – in group III compared the control group (P < 0.05); early gestosis occurred 1.9 times more often in group I, 2.5 times – in group II, 3.3 times – in group III as compared to that in pregnant women of the control group (P < 0.05); the threat of premature birth was found 3.4 times more frequently in group I, 5.6 times – in group II, 7.5 times – in group III as compared with the control group (P < 0.05). Group I patients developed placental dysfunction with a frequency of 2.3 times, group II – of 4.0 times, and group III – of 6.3 times greater than pregnant women of the control group (P < 0.05), and moderate preeclampsia was diagnosed in overweight pregnant women, as well as in women with grade I and grade II–III obesity 2.3 times, 4.7 times and 5.6 times as often, respectively, as in the control group (P < 0.05). Correlation analysis showed correlations between lipid metabolism indicators and an increase in BMI. Conclusions. Obese pregnant women with NAFLD at the stage of NASH were found to have significantly more frequent obstetric and perinatal complications as well as lipid profile abnormalities correlating with increased BMI, which may be due to the presence of NASH and functional liver failure.