Maternal and Perinatal Risk Factors for Pediatric Nonalcoholic Fatty Liver Disease: A Systematic Review
| Autor: | Ellen Dupont, Xavier Verhelst, Anja Geerts, Nele S. Pauwels, Hans Van Vlierberghe, Ilya Querter, Lindsey Devisscher, Ruth De Bruyne, Sander Lefere |
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| Rok vydání: | 2021 |
| Předmět: |
Pediatrics
medicine.medical_specialty Prepregnancy Weight Adolescent Breastfeeding Birthweight Overweight Non-alcoholic Fatty Liver Disease Pregnancy Risk Factors NAFLD Nonalcoholic fatty liver disease medicine Medicine and Health Sciences Humans Obesity Risk factor Gestational Diabetes Child Hepatology business.industry Gastroenterology Infant Newborn nutritional and metabolic diseases Odds ratio medicine.disease digestive system diseases Gestational diabetes Small for gestational age Premature Birth Female medicine.symptom Steatohepatitis business |
| Zdroj: | CLINICAL GASTROENTEROLOGY AND HEPATOLOGY |
| ISSN: | 1542-7714 1542-3565 |
| Popis: | Background & Aims Nonalcoholic fatty liver disease (NAFLD) has become the most common pediatric liver disease. The intrauterine and early life environment can have an important impact on long-term metabolic health. We investigated the impact of maternal prepregnancy obesity, (pre)gestational diabetes, breastfeeding, and birth anthropometrics/preterm birth on the development of NAFLD in children and adolescents. Methods A comprehensive search was performed in MEDLINE, PubMed Central, EMBASE, and grey literature databases through August 2020. The primary outcome was the prevalence of pediatric NAFLD, whereas the histologic severity of steatohepatitis and/or fibrosis were secondary outcomes. Study selection, data extraction, and quality assessment were performed by 2 independent reviewers. Results Our systematic review included 33 articles. Study heterogeneity regarding patient populations, diagnostic tools, and overall quality was considerable. Eight studies determined the impact of maternal prepregnancy overweight/obesity and identified this as a possible modifiable risk factor for pediatric NAFLD. Conversely, 8 studies investigated (pre)gestational diabetes, yet the evidence on its impact is conflicting. Breastfeeding was associated with a reduced risk for NAFLD, steatohepatitis, and fibrosis, especially in studies that evaluated longer periods of breastfeeding. Being born preterm or small for gestational age has an unclear impact on the development of NAFLD, although an early catch-up growth might drive NAFLD. Conclusions In a systematic review, we found that maternal prepregnancy overweight and obesity were associated with an increased risk of pediatric NAFLD. Breastfeeding might be protective against the development of NAFLD when the duration of breastfeeding is sufficiently long (≥6 months). |
| Databáze: | OpenAIRE |
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