Meta-analysis of maternal overweight/obesity during pregnancy and offspring metabolic dysfunction-associated steatotic liver disease

WU Yuying; ENKAER Nuer; WANG Youxin; WANG Mingyue; YANG Yifan; YANG Shuhan; SUN Lingling; WANG Hui

doi:10.16835/j.cnki.1000-9817.2025259

Volume 46 Issue 8

Aug. 2025

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WU Yuying, ENKAER Nuer, WANG Youxin, WANG Mingyue, YANG Yifan, YANG Shuhan, SUN Lingling, WANG Hui. Meta-analysis of maternal overweight/obesity during pregnancy and offspring metabolic dysfunction-associated steatotic liver disease[J]. CHINESE JOURNAL OF SCHOOL HEALTH, 2025, 46(8): 1079-1083. doi: 10.16835/j.cnki.1000-9817.2025259

Citation:

WU Yuying, ENKAER Nuer, WANG Youxin, WANG Mingyue, YANG Yifan, YANG Shuhan, SUN Lingling, WANG Hui. Meta-analysis of maternal overweight/obesity during pregnancy and offspring metabolic dysfunction-associated steatotic liver disease[J]. CHINESE JOURNAL OF SCHOOL HEALTH, 2025, 46(8): 1079-1083. doi: 10.16835/j.cnki.1000-9817.2025259

Citation:

WU Yuying, ENKAER Nuer, WANG Youxin, WANG Mingyue, YANG Yifan, YANG Shuhan, SUN Lingling, WANG Hui. Meta-analysis of maternal overweight/obesity during pregnancy and offspring metabolic dysfunction-associated steatotic liver disease[J]. CHINESE JOURNAL OF SCHOOL HEALTH, 2025, 46(8): 1079-1083. doi: 10.16835/j.cnki.1000-9817.2025259

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Meta-analysis of maternal overweight/obesity during pregnancy and offspring metabolic dysfunction-associated steatotic liver disease

doi: 10.16835/j.cnki.1000-9817.2025259

WU Yuying^{1, 2},
ENKAER Nuer^{1, 2},
WANG Youxin^{1, 2},
WANG Mingyue^{1, 2},
YANG Yifan^{1, 2},
YANG Shuhan^{1, 2},
SUN Lingling^{2, 3
,
,},
WANG Hui^{1, 2
,
,}

1.
Department of Maternal and Child Health, School of Public Health, Peking University, Beijing 100191, China

Received Date: 2025-02-14
Rev Recd Date: 2025-04-30

Available Online: 2025-08-30

Publish Date: 2025-08-25

Abstract

Abstract

Objective To evaluates the association between maternal overweight/obesity during pregnancy and offspring risk of metabolic dysfunction-associated steatotic liver disease (MASLD), providing theoretical evidence for early-life MASLD prevention. Methods An online search was conducted across ten databases (CNKI, Wanfang, SinoMed, PubMed, Embase, Web of Science, Cochrane Library, PROSPERO, PQDT Global, ScienceDirect) for research literature on the association between maternal overweight/obesity during pregnancy and the development of MASLD in offspring, with the search period spanning from January 2014 to December 2024. Two researchers independently screened literature, extracted data, and assessed study quality. Statistical analysis was performed using R 4.3.3. Results Ten studies involving 10 229 participants were included, comprising 4 cohort studies and 6 case-control studies. Cohort studies showed that maternal overweight and obesity significantly increased offspring MASLD risk (RR=1.59, 95%CI=1.06-2.39, P < 0.05), with moderate heterogeneity (I²=56.9%, P=0.07). Case-control studies indicated a positive association between maternal overweight/obesity during pregnancy and offspring risk of MASLD(OR=2.00, 95%CI=1.68-2.39, P < 0.05), with low heterogeneity (I²=48.8%, P=0.08). Conclusions Maternal overweight/obesity during pregnancy positively correlates with offspring MASLD risk. Gestational weight management may reduce the risk.
- Pregnancy,
- Overweight,
- Obesity,
- Fatty liver,
- Meta-analysis

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References(37)

References

[1]	OECD, WHO. Health at a glance: Asia/Pacific 2024[M]. Paris: OECD, 2024.
[2]	SOLMI F, MORRIS S. Overweight and obese pre-pregnancy BMI is associated with higher hospital costs of childbirth in England[J]. BMC Pregnancy Childbirth, 2018, 18(1): 253. doi: 10.1186/s12884-018-1893-z
[3]	CHEN C, XU X, YAN Y. Estimated global overweight and obesity burden in pregnant women based on panel data model[J]. PLoS One, 2018, 13(8): e0202183. doi: 10.1371/journal.pone.0202183
[4]	NORMAN J E, REYNOLDS R M. The consequences of obesity and excess weight gain in pregnancy[J]. Proceed Nutr Soc, 2011, 70(4): 450-456. doi: 10.1017/S0029665111003077
[5]	HESLEHURST N, NGONGALAH L, BIGIRUMURAME T, et al. Association between maternal adiposity measures and adverse maternal outcomes of pregnancy: systematic review and Meta-analysis[J]. Obesity Rev, 2022, 23(7): e13449. doi: 10.1111/obr.13449
[6]	BARBOUNI K, JOTAUTIS V, METALLINOU D, et al. When weight matters: how obesity impacts reproductive health and pregnancy: a systematic review[J]. Current Obes Reports, 2025, 14(1): 37. doi: 10.1007/s13679-025-00629-9
[7]	ZELJKOVIC A, VEKIC J, STEFANOVIC A. Obesity and dyslipidemia in early life: impact on cardiometabolic risk[J]. Metabolism, 2024, 156: 155919. doi: 10.1016/j.metabol.2024.155919
[8]	RIVERA-AGUIRRE J. Desarrollo temprano de hígado graso no alcohólico por exposición fetal a obesidad gestacional. Revisión de tema[J]. Med UIS, 2023, 36(3): 9-19.
[9]	范建高, 徐小元, 南月敏, 等. 代谢相关(非酒精性)脂肪性肝病防治指南(2024年版)[J]. 实用肝脏病杂志, 2024, 27(4): 494-510. FAN J G, XU X Y, NAN Y M, et al. Guidelines for the prevention and treatment of metabolic dysfunction-associated (non-alcoholic) fatty liver disease(Version 2024)[J]. J Pract Hepatol, 2024, 27(4): 494-510. (in Chinese)
[10]	YOUNOSSI Z M, KOENIG A B, ABDELATIF D, et al. Global epidemiology of nonalcoholic fatty liver disease: Meta-analytic assessment of prevalence, incidence, and outcomes[J]. Hepatology (Baltimore, Md.), 2016, 64(1): 73-84. doi: 10.1002/hep.28431
[11]	耿坐涛, 张丹, 朱筱桐, 等. 儿童非酒精性脂肪性肝病危险因素的研究进展[J]. 中国儿童保健杂志, 2024, 32(4): 412-418. GENG Z T, ZHANG D, ZHU X T, et al. Risk factors of non-alcoholic fatty liver disease in children[J]. Chin Child Health Care, 2024, 32(4): 412-418. (in Chinese)
[12]	SCHWIMMER J B, DEUTSCH R, KAHEN T, et al. Prevalence of fatty liver in children and adolescents[J]. Pediatrics, 2006, 118(4): 1388-1393. doi: 10.1542/peds.2006-1212
[13]	VOS M B, ABRAMS S H, BARLOW S E, et al. NASPGHAN clinical practice guideline for the diagnosis and treatment of nonalcoholic fatty liver disease in children: recommendations from the expert committee on NAFLD (ECON) and the north American society of pediatric gastroenterology, hepatology and nutrition (NASPGHAN)[J]. J Pediatr Gastroenterol Nutr, 2017, 64(2): 319-334. doi: 10.1097/MPG.0000000000001482
[14]	SARKAR M, GRAB J, DODGE J L, et al. Non-alcoholic fatty liver disease in pregnancy is associated with adverse maternal and perinatal outcomes[J]. J Hepatol, 2020, 73(3): 516-522. doi: 10.1016/j.jhep.2020.03.049
[15]	COCHRANE A L K, MURPHY M P, OZANNE S E, et al. Pregnancy in obese women and mechanisms of increased cardiovascular risk in offspring[J]. Europ Heart J, 2024, 45(48): 5127-5145. doi: 10.1093/eurheartj/ehae671
[16]	BAIRD J, JACOB C, BARKER M, et al. Developmental origins of health and disease: a lifecourse approach to the prevention of non-communicable diseases[J]. Healthcare (Basel), 2017, 5(1): 14.
[17]	ZENG J, SHEN F, ZOU Z Y, et al. Association of maternal obesity and gestational diabetes mellitus with overweight/obesity and fatty liver risk in offspring[J]. World J Gastroenterol, 2022, 28(16): 1681-1691. doi: 10.3748/wjg.v28.i16.1681
[18]	PATEL S, LAWLOR D A, CALLAWAY M, et al. Association of maternal diabetes/glycosuria and pre-pregnancy body mass index with offspring indicators of non-alcoholic fatty liver disease[J]. BMC Pediatr, 2016, 16: 47. doi: 10.1186/s12887-016-0585-y
[19]	HAGSTRÖM H, SIMON T G, ROELSTRAETE B, et al. Maternal obesity increases the risk and severity of NAFLD in offspring[J]. J Hepatol, 2021, 75(5): 1042-1048. doi: 10.1016/j.jhep.2021.06.045
[20]	ABEYSEKERA K W M, ORR J G, MADLEY-DOWD P, et al. Association of maternal pre-pregnancy BMI and breastfeeding with NAFLD in young adults: a parental negative control study[J]. Lancet Reg Health-Europ, 2021(10): 100206.
[21]	NAIRZ J, MESSNER A, KIECHL S J, et al. Determinants of non-alcoholic fatty liver disease in young people: maternal, neonatal, and adolescent factors[J]. PLoS One, 2024, 19(2): e0298800. doi: 10.1371/journal.pone.0298800
[22]	DE RUYTER H, AITOKARI L, LAHTI S, et al. Maternal gestational hypertension, smoking and pre-eclampsia are associated with metabolic dysfunction-associated fatty liver disease in overweight offspring[J]. Acta Obstetr Gynecol Scand, 2024, 103(6): 1183-1191. doi: 10.1111/aogs.14816
[23]	BRUMBAUGH D E, TEARSE P, CREE-GREEN M, et al. Intrahepatic fat is increased in the neonatal offspring of obese women with gestational diabetes[J]. J Pediatr, 2013, 162(5): 930-936. doi: 10.1016/j.jpeds.2012.11.017
[24]	PAGE M J, MCKENZIE J E, BOSSUYT P M, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews[J]. BMJ, 2021, 372: n71.
[25]	RICHARDSON W S, WILSON M C, NISHIKAWA J, et al. The well-built clinical question: a key to evidence-based decisions[J]. ACP J Club, 1995, 123(3): A12-A13. doi: 10.7326/ACPJC-1995-123-3-A12
[26]	WELLS G, SHEA B, O'CONNELL D, et al. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in Meta-analyses[EB/OL]. (2014)[2025-02-05]. http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp.
[27]	HIGGINS J P T, THOMPSON S G. Quantifying heterogeneity in a Meta-analysis[J]. Stat Med, 2002, 21(11): 1539-1558. doi: 10.1002/sim.1186
[28]	GEURTSEN M L, WAHAB R J, FELIX J F, et al. Maternal early-pregnancy glucose concentrations and liver fat among school-age children[J]. Hepatology, 2021, 74(4): 1902-1913.
[29]	BELLATORRE A, SCHERZINGER A, STAMM E, et al. Fetal overnutrition and adolescent hepatic fat fraction: the exploring perinatal outcomes in children study[J]. J Pediatr, 2018, 192: 165-170.
[30]	CANTORAL A, MONTOYA A, LUNA-VILLA L, et al. Overweight and obesity status from the prenatal period to adolescence and its association with non-alcoholic fatty liver disease in young adults: cohort study[J]. Bjog Int J Obstetr Gynaecol, 2020, 127(10): 1200-1209.
[31]	AYONRINDE O T, ADAMS L A, MORI T A, et al. Sex differences between parental pregnancy characteristics and nonalcoholic fatty liver disease in adolescents[J]. Hepatology, 2018, 67(1): 108-122.
[32]	SONG R, LI Z, ZHANG Y, et al. Comparison of NAFLD, MAFLD and MASLD characteristics and mortality outcomes in United States adults[J]. Liver Int, 2024, 44(4): 1051-1060.
[33]	NYASORDZI J, CONRAD J, GOLETZKE J, et al. Early life factors and their relevance for markers of cardiometabolic risk in early adulthood[J]. Nutr Metab Cardiovasc Dis, 2021, 31(7): 2109-2121.
[34]	PENG L, SHEN J, LI L, et al. Birthweight influences liver structure, function and disease risk: evidence of a causal association[J]. Diabetes Obes Metab, 2024, 26(11): 4976-4988.
[35]	EBRAHIMI F, YAO J, HAGSTROEM H, et al. Birth weight, gestational age, and risk of pediatric-onset MASLD[J]. JAMA Network Open, 2024, 7(9): e2432420.
[36]	KLEPPER C. Maternal nonalcoholic fatty liver disease: a driver of fetal hepatic steatosis?[D]. Cincinnati: University of Cincinnati, 2022.
[37]	MOURALIDARANE A, SOEDA J, LIN C I, et al. Maternal obesity during pregnancy and lactation programs development of non-alcoholic fatty liver disease in offspring fed a postnatal hyper-calorific diet[J]. Reprod Sci, 2011, 18(3): 216A.