Non-alcoholic fatty liver disease (NAFLD) risks cardiovascular disease (CVD) in non-pregnant adults. The biological mechanisms underlying this association are unclear but metabolic factors, inflammation, and endothelial dysfunction is thought to be involved. The association between NAFLD and pregnancy-associated hypertension (HTN) remains poorly understood. So a study assessed the risk of pregnancy-associated HTN in pregnant women with NAFLD.

The study enrolled healthy pregnant women who underwent Liver ultrasonography at 10-14 weeks of gestation and measurement of maternal blood selenoprotein P (SeP), a hepatokine independently associated with both NAFLD and CVD. 

Pregnancy-associated HTN explained the development of gestational HTN, preeclampsia, or eclampsia.

The following observations were made-

• 877 pregnant women were enrolled on the study. 
• Women with NAFLD had a significantly increased risk of developing pregnancy-associated HTN compared to those without NAFLD.
• Grade 2-3 steatosis significantly predicted pregnancy-associated HTN, even after adjusting for metabolic risk factors. 
• Women with NAFLD and women who subsequently developed pregnancy-associated HTN had significantly higher levels of Circulating SeP than those without NAFLD and those who did not subsequently develop pregnancy-associated HTN.

Thus, Sonographic evidence of NAFLD at 10-14 weeks independently predicts pregnancy-associated HTN. Circulating levels of SeP at that same gestational age are remarkably increased in pregnant women with NAFLD who thereafter acquire pregnancy-associated HTN.

SOURCE- Jung YM, Lee SM, Hong S, Koo JN, Oh IH, Kim BJ. el al. The risk of pregnancy-associated hypertension in women with non-alcoholic fatty liver disease, Liver International, 2020;40(10):2417-2426