Birth Weight, Gestational Age, and Risk of Pediatric-Onset MASLD

This case-control study investigates the association of birth weight and gestational age with risk of metabolic dysfunction–associated steatotic liver disease (MASLD) among children, adolescents, and young adults in Sweden.


Pediatric-specific
We excluded any person with prior use of a steatogenic medication or a medication used to treat an alternative etiology of liver disease.Medication use was defined by a filled prescription for at least 30 cumulative defined daily doses (cDDD), in the Prescribed Drug Register, at any time prior to the index date (or corresponding matching date), with the exception of systemic steroids (for which a person was excluded if they used systemic steroids within 0 to 3 months prior to the index date

Definition of Baseline Covariates in Mothers Baseline covariates
). Abbreviations: ATC, anatomic therapeutic chemical classification; HIV, human immunodeficiency virus; ICD, International Classification of Disease.(up until and including date of biopsy/matching date) © 2024 Ebrahimi F et al.JAMA Network Open.eTable 2.

in study subjects at date of MASLD diagnosis/matching
*Vaginal instrumental delivery refers to either vacuum extraction or forceps delivery.#Education categories based on compulsory school, high school, and college.Abbreviations: AGA, appropriate for gestational age; BMI, body mass index; LGA, large for gestational age; MASLD, metabolic dysfunction-associated steatotic liver disease; MASH, metabolic dysfunction-associated steatohepatitis; SGA, small for gestational age.©2024 Ebrahimi F et al.JAMA Network Open.eTable 4.

Sensitivity Analyses on Odds of MASLD and Progressive Liver Disease
Conditional logistic regression matched for age at index date, sex, calendar year, and county of residence and further adjusted for maternal age, maternal early-pregnancy body mass index, maternal country of birth, parity, highest level of education in parents, and smoking in early pregnancy as well as pre-eclampsia and gestational diabetes.

Odds of MASLD in Restricted Cohort ≥2 years of Age at Time of MASLD Diagnosis
* Model I: Conditional logistic regression matched for age at index date, sex, calendar year, and county of residence.**ModelII: Model I and further adjusted for maternal age, maternal early-pregnancy body mass index, maternal country of birth, parity, highest level of education in parents, and smoking in early pregnancy.Abbreviations: AGA, appropriate for gestational age; CI, Confidence interval; LGA, large for gestational age; MASLD, metabolic dysfunctionassociated steatotic liver disease; aOR, adjusted odds ratio; SGA, small for gestational age.eTable 6.

Odds of MASLD in Restricted Cohort for Individuals diagnosed with MASLD from 2004 onwards
* Model I: Conditional logistic regression matched for age at index date, sex, calendar year, and county of residence.**ModelII: Model I and further adjusted for maternal age, maternal early-pregnancy body mass index, maternal country of birth, parity, highest level of education in parents, and smoking in early pregnancy.Abbreviations: AGA, appropriate for gestational age; CI, Confidence interval; LGA, large for gestational age; MASLD, metabolic dysfunctionassociated steatotic liver disease; aOR, adjusted odds ratio; SGA, small for gestational age.eTable 7.

Odds of MASLD among Females and Males
Conditional logistic regression matched for age at index date, sex, calendar year, and county of residence.**Model II: Model I and further adjusted for maternal age, maternal early-pregnancy body mass index, maternal country of birth, parity, highest level of education in parents, and smoking in early pregnancy.Abbreviations: AGA, appropriate for gestational age; CI, Confidence interval; LGA, large for gestational age; MASLD, metabolic dysfunctionassociated steatotic liver disease; aOR, adjusted odds ratio; SGA, small for gestational age.

in study subjects at date of MASLD diagnosis/follow-up
*Vaginal instrumental delivery refers to either vacuum extraction or forceps delivery.#Education categories based on compulsory school, high school, and college.Abbreviations: AGA, appropriate for gestational age; BMI, body mass index; LGA, large for gestational age; MASLD, metabolic dysfunction-associated steatotic liver disease; MASH, metabolic dysfunctionassociated steatohepatitis; SGA, small for gestational age.eTable 9.

Birthweight, Gestational Age and Future Odds of MASLD -Sibling-Controlled Analysis
Conditional logistic regression conditioned on family and further adjusted for age, sex, and birthyear.**Model II: Model I and further adjusted for maternal age, maternal early-pregnancy BMI, maternal country of birth, parity, highest level of education in parents, and smoking in early pregnancy.Abbreviations: AGA, appropriate for gestational age; CI, Confidence interval; LGA, large for gestational age; MASLD, metabolic dysfunctionassociated steatotic liver disease; aOR, adjusted odds ratio; SGA, small for gestational age.