A recent study (KP Newton et al. J Pediatr 2017; 187: 141-6; associated editorial pg 13-15)) in a multicenter retrospective cross-sectional study of children (n=538) with biopsy-proven nonalcoholic fatty liver disease (NAFLD) showed that birth weight influenced the development of NAFLD. The participants were enrolled in the Nonalcoholic Steatohepatitis Clinical Research Network (NASH CRN).
- There was increased NAFLD among both low birth weight (LBW) and high birth weight (HBW).
- LBW occurred more commonly in the NAFLD cohort 9.3% compared with the general population prevalence 6.1%.
- HBW occurred more commonly in the NAFLD cohort 14.9% compared with the general population prevalence 10.5%
The authors speculate that the explanation/mechanisms for increase in both LBW and HBW are likely to differ. It has been recognized that LBW is associated with higher cardiovascular disease and type 2 diabetes. HBW start bigger and often stay bigger; that is, there are increased risks of more severe obesity.
There are numerous limitations to this study -there is a lot of data that is not available, including gestational age, maternal weight, breastfeeding exposure, and antibiotic administration.
My take: These findings add to the literature that risks for NAFLD along with other metabolic problems may be present at birth. Is there a way to modify this risk?
Related study: ET Jensen et al. J Pediatr 2017; 187: 50-7, editorial pg 10-12. In this study of 535 ten-year-old children, enrolled in a prospective multicenter extremely low gestational age newborn cohort study, the authors found that maternal overnutrition and undernutrition affected the brain health of these children. The authors used neurocognitive assessment tools.
- Children born to women with a pregravid BMI >30 scored “lower on measures of general cognitive ability, executive functioning, fine motor function, and academic achievement.”
- Children born to women with inadequate maternal weight gain during pregnancy had “lower language and academic achievement.”