What I Wish I Knew About MASLD and Pregnancy

“You were pregnant while having MASLD? How?”

I’m amazed by the frequency of this question being asked in some way, shape, or form. I have talked before about how I felt as though my diagnosis of metabolic dysfunction-associated steatotic liver disease (MASLD) was kind of “brushed off” by my gastroenterologist. It is something that never sat well with me. It led me to have to self-educate on all things liver health, MASLD, metabolic dysfunction-associated steatohepatitis (MASH), hepatic steatosis, fibrosis, etc.

My doctor seemed to conveniently omit the fact that having a fatty liver can potentially increase the risk of complications… not just for the mother, but also for the baby. It’s something that I never even considered; how was I to know? In fact, if it weren’t for the comments I was receiving on my social media platforms, the connection between a fatty liver and pregnancy would have never crossed my mind.

The double-edged sword of not knowing

It is both a blessing and a curse that I didn’t find out about these risks until after both of my pregnancies had ended (healthily, thankfully). Why a blessing? Because it was one less stress for me to have to maneuver during my 9 months of growing a life. Why a curse? I was absolutely blind to a situation that could have potentially brought harm to myself and my baby.

I started questioning everything: is that why I failed the first gestational diabetes test, only to have to have the 3-hour test done? (I passed). Is this why I had a month of low amniotic fluid? Is this why, at a couple of my appointments, my usually perfect blood pressure was reading abnormally high for me? Things that I experienced that could have thousands of other explanations as to why they happened… could have also simply been from my MASLD.

Understanding the risks of MASLD during pregnancy

According to a study by the University of California, San Francisco, “pregnant women with the metabolic condition known as metabolic dysfunction-associated steatotic liver disease (MASLD) have more than four times the risk of serious adverse maternal-fetal outcomes, such as hypertensive complications, bleeding after delivery, and pre-term birth.”¹

I do not share this information to scare anyone, but to raise awareness among others so that they are informed and in tune with their bodies as they prepare to start a family. Having nonalcoholic fatty liver disease while pregnant is a significant consideration. It’s something that I wish I had known, simply so that I could have received some counseling on how to maneuver the risks and manage the potential side effects.