Pregnancy and Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD)

Introduction . Metabolic dysfunction‑associated steatotic liver disease (MASLD) demonstrates a significant prevalence among women of reproductive age (approximately 10 %), yet the pathophysiological mechanisms of its impact on gestation remain insufficiently understood, and management algorithms for patients before, during, and after pregnancy are lacking. Purpose of the work is to review the scientific literature and summarise current data on the epidemiology, pathophysiology, and maternal/perinatal risks of MASLD in pregnancy, and to present diagnostic and therapeutic strategies from pregravid through postpartum care. Materials and methods . A search of articles was conducted in the PubMed database using the following keywords: metabolic dysfunction-associated steatotic liver disease, MASLD, pregnancy, gestational diabetes mellitus, obesity, pregnancy outcomes. Results and discussion . MASLD is highly prevalent among women of reproductive age and during pregnancy and associated with higher risk of developing gestational diabetes, pre-eclampsia, and preterm birth. Currently, there are no guidelines for routine screening for MASLD during pregnancy; however, women with metabolic disorders are recommended to undergo imaging investigations and laboratory panels to assess liver function. Liver fibrosis assessment should be performed before pregnancy to identify cases of cirrhosis. For women with MASLD, acetylsalicylic acid is recommended to reduce pre-eclampsia risk. In the absence of cirrhosis signs, additional monitoring of liver function is not required. Breastfeeding has been associated with beneficial effects on maternal and child metabolic health. Conclusion . MASLD prevalence in pregnancy is rising, increasing risks of adverse maternal and perinatal outcomes. Further studies on long‑term risks and safety of MASLD therapy during gestation and lactation are needed.