Predictivity of Hepatic Steatosis Index for Gestational Hypertension and Preeclampsia: a Prospective Cohort Study.

Context: Previous studies have reported that pregnant women with non-alcoholic fatty liver disease (NAFLD) face an increased risk of gestational hypertension (GH) and preeclampsia (PE). However, no study has assessed the relationship between the Hepatic Steatosis Index (HSI), a biomarker for NAFLD, in early pregnancy and the subsequent risk of GH and PE.

Objective

We aimed to investigate the relationship between HSI in early pregnancy and the risks of GH and PE in Chinese women.

Methods

Based on the China Birth Cohort Study conducted from February 2018 to December 2022, this prospective cohort study collected liver enzyme and body mass index data from pregnant participants during 6-13+6 gestational weeks. The incidences of GH and PE were monitored until delivery.

Results

This study included 39,114 pregnant women, and GH and PE incidences were 4.2% and 4.1%, respectively. After multivariable adjustment, the risks of GH (Q2: OR = 1.35, 95% CI = 1.13-1.62; Q3: OR = 1.86, 95% CI = 1.57-2.20; Q4: OR = 3.81, 95% CI = 3.25-4.46) and PE (Q2: OR = 1.22, 95% CI = 1.01-1.47; Q3: OR = 1.96, 95% CI = 1.65-2.32; Q4: OR = 3.60, 95% CI = 3.07-4.22) significantly increased with higher HSI quartiles. Further analysis indicated that compared to women aged 35 years or older, HSI in pregnant women under 35 years had relatively stronger predictive value for GH (OR ≥ 35 = 4.527, 95% CI = 3.762-5.446 vs. OR < 35 = 2.325, 95% CI = 1.729-3.128) and PE (OR ≥ 35 = 4.13, 95% CI = 3.433-4.983 vs. OR < 35 = 2.348, 95% CI = 1.736-3.176).

Conclusion

Elevated HSI may be associated with an increased risk of GH and PE.