Pregnant women with a common type of fatty liver disease face a significantly higher risk of preterm delivery, according to a new study from Sweden.
Researchers from the Karolinska Institute have found that women with metabolic dysfunction-associated steatotic liver disease (MASLD) — formerly known as non-alcoholic fatty liver disease (NAFLD) — are over three times more likely to give birth prematurely compared to women without the condition.

MASLD is a growing global health concern, closely linked to obesity, type 2 diabetes, and metabolic disorders. Its prevalence is rising among women of reproductive age, making the study’s findings especially relevant.
Key Findings:
- Women with MASLD had a more than threefold increased risk of preterm birth.
- This elevated risk persisted even when compared to overweight or obese women without MASLD, indicating that the liver disease itself plays a role independent of BMI.
- The condition was also associated with a 63% higher risk of caesarean delivery compared to the general population. However, this risk was not elevated when compared specifically to overweight or obese women, suggesting BMI was the main factor in that case.
- No increased risk was found for congenital malformations or stillbirths in babies born to mothers with MASLD.

“This suggests that the association is not only due to a high body mass index and that the liver disease itself can have negative effects,” said Carole A. Marxer, lead author and postdoctoral researcher at the Department of Medical Epidemiology and Biostatistics, Karolinska Institute.
The study, published in eClinicalMedicine, analyzed Swedish registry data, including 240 births among women diagnosed with MASLD and 1,140 matched births from the general population.
Clinical Implications:
Experts say the findings highlight the need for closer monitoring of pregnant women with MASLD.
“It is important that pregnant women with MASLD are closely monitored during pregnancy to reduce the risk of complications,” said Marxer. “Consideration should also be given to updating clinical guidelines to include specific recommendations for pregnant women with MASLD.”
While other factors may influence these risks, the study emphasizes the importance of recognizing MASLD as an independent concern in pregnancy outcomes.