MASLD in Pregnancy Rising Rapidly, Linked to Increased Maternal Morbidity
Metabolic dysfunction–associated steatotic liver disease (MASLD) is increasing sharply among pregnant patients in the United States and is associated with higher maternal morbidity, according to a large national analysis of inpatient data presented at Digestive Disease Week 2026.
The findings highlight a growing clinical burden in a population already at elevated metabolic risk.
Investigators analyzed more than 21 million pregnancies recorded in the National Inpatient Sample between 2016 and 2021. Among these, 16,969 patients were identified with MASLD. Prevalence nearly tripled over the study period, rising from 45.7 to 122.4 cases per 100,000 pregnancies.
Patients with MASLD were older and had a higher burden of cardiometabolic comorbidities compared with those without liver disease or with other chronic liver conditions. After adjusting for confounders, MASLD was independently associated with adverse maternal outcomes. Compared with other chronic liver diseases, MASLD was linked to significantly higher rates of hypertensive complications, including preeclampsia, eclampsia, and HELLP syndrome (adjusted odds ratio [aOR], 2.59), as well as increased risk of preterm birth and cesarean delivery.
When compared with patients without liver disease, MASLD remained associated with elevated risks of hypertensive complications (aOR, 1.90), preterm birth (aOR, 1.45), and postpartum hemorrhage (aOR, 1.32). Hospitalization burden was also greater, with longer lengths of stay and higher costs.
The authors reported that MASLD showed a “nearly threefold rise over the study period” and was “independently associated with significantly higher morbidity.” They emphasized that these trends “underscore a need for improved recognition and early management of the disease.”
Importantly, fetal outcomes such as growth restriction and fetal death did not differ significantly across groups, suggesting the primary impact may be on maternal health.
Reference
Maria Grba M, Pinnam HS, Akande Y, et al. The growing impact of MASLD on pregnancy-related outcomes: A national analysis. Presented at: Digestive Disease Week; May 2–5, 2026; Chicago, Illinois.
