Evidence map›Paper›PMID 41737674›Full record

ArticleThe Lancet. Obstetrics, gynaecology, & women's health2026

Evaluating metabolic dysfunction-associated steatotic liver disease, associated adverse pregnancy outcomes, and postpartum maternal course utilising transient elastography with controlled attenuation parameter in pregnancy: a prospective cohort study.

Marcia Lange, Jeanette Rios, Cecilia Katzenstein, Theresa Worthington, Carin Carroll, Nina Rodriguez, Rachel Meislin, Pamela Argiriadi, Sonam Rosberger, Emma Rosenbluth and 4 more

Abstract read

PubMed Full text at PMC Publisher

In one paragraph

Article in The Lancet. Obstetrics, gynaecology, & women's health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it

0cells of the map it votes in

1citing papers in PubMed

–field-weighted citation impact

1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

Hepatology: Emerging Paradigms in MASLD, Viral Hepatitis, Cholestatic Liver Disease, Portal Hypertension and Hepatocellular Carcinoma: Summary of the First Annual Paris International Liver Meeting 2026.Liver international : official journal of the International Association for the Study of the Liver · 2026
Review

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Marcia Lange(M Lange MD); (M Lange, C Katzenstein BA, T Worthington BSBA, N Rodriguez BA, K Sigel MD); (J Rios MD); (C Carroll MD); (R Meislin MD, Prof R Sperling MD); (P Argiriadi MD, S Rosberger MD); (E Rosenbluth MD, Prof N A Terrault MD); (T Kushner MD).

Jeanette Rios(M Lange MD); (M Lange, C Katzenstein BA, T Worthington BSBA, N Rodriguez BA, K Sigel MD); (J Rios MD); (C Carroll MD); (R Meislin MD, Prof R Sperling MD); (P Argiriadi MD, S Rosberger MD); (E Rosenbluth MD, Prof N A Terrault MD); (T Kushner MD).

Cecilia Katzenstein(M Lange MD); (M Lange, C Katzenstein BA, T Worthington BSBA, N Rodriguez BA, K Sigel MD); (J Rios MD); (C Carroll MD); (R Meislin MD, Prof R Sperling MD); (P Argiriadi MD, S Rosberger MD); (E Rosenbluth MD, Prof N A Terrault MD); (T Kushner MD).

Theresa Worthington(M Lange MD); (M Lange, C Katzenstein BA, T Worthington BSBA, N Rodriguez BA, K Sigel MD); (J Rios MD); (C Carroll MD); (R Meislin MD, Prof R Sperling MD); (P Argiriadi MD, S Rosberger MD); (E Rosenbluth MD, Prof N A Terrault MD); (T Kushner MD).

Carin Carroll(M Lange MD); (M Lange, C Katzenstein BA, T Worthington BSBA, N Rodriguez BA, K Sigel MD); (J Rios MD); (C Carroll MD); (R Meislin MD, Prof R Sperling MD); (P Argiriadi MD, S Rosberger MD); (E Rosenbluth MD, Prof N A Terrault MD); (T Kushner MD).

Nina Rodriguez(M Lange MD); (M Lange, C Katzenstein BA, T Worthington BSBA, N Rodriguez BA, K Sigel MD); (J Rios MD); (C Carroll MD); (R Meislin MD, Prof R Sperling MD); (P Argiriadi MD, S Rosberger MD); (E Rosenbluth MD, Prof N A Terrault MD); (T Kushner MD).

Rachel Meislin(M Lange MD); (M Lange, C Katzenstein BA, T Worthington BSBA, N Rodriguez BA, K Sigel MD); (J Rios MD); (C Carroll MD); (R Meislin MD, Prof R Sperling MD); (P Argiriadi MD, S Rosberger MD); (E Rosenbluth MD, Prof N A Terrault MD); (T Kushner MD).

Pamela Argiriadi(M Lange MD); (M Lange, C Katzenstein BA, T Worthington BSBA, N Rodriguez BA, K Sigel MD); (J Rios MD); (C Carroll MD); (R Meislin MD, Prof R Sperling MD); (P Argiriadi MD, S Rosberger MD); (E Rosenbluth MD, Prof N A Terrault MD); (T Kushner MD).

Sonam Rosberger(M Lange MD); (M Lange, C Katzenstein BA, T Worthington BSBA, N Rodriguez BA, K Sigel MD); (J Rios MD); (C Carroll MD); (R Meislin MD, Prof R Sperling MD); (P Argiriadi MD, S Rosberger MD); (E Rosenbluth MD, Prof N A Terrault MD); (T Kushner MD).

Emma Rosenbluth(M Lange MD); (M Lange, C Katzenstein BA, T Worthington BSBA, N Rodriguez BA, K Sigel MD); (J Rios MD); (C Carroll MD); (R Meislin MD, Prof R Sperling MD); (P Argiriadi MD, S Rosberger MD); (E Rosenbluth MD, Prof N A Terrault MD); (T Kushner MD).

Rhoda Sperling(M Lange MD); (M Lange, C Katzenstein BA, T Worthington BSBA, N Rodriguez BA, K Sigel MD); (J Rios MD); (C Carroll MD); (R Meislin MD, Prof R Sperling MD); (P Argiriadi MD, S Rosberger MD); (E Rosenbluth MD, Prof N A Terrault MD); (T Kushner MD).

Keith Sigel(M Lange MD); (M Lange, C Katzenstein BA, T Worthington BSBA, N Rodriguez BA, K Sigel MD); (J Rios MD); (C Carroll MD); (R Meislin MD, Prof R Sperling MD); (P Argiriadi MD, S Rosberger MD); (E Rosenbluth MD, Prof N A Terrault MD); (T Kushner MD).

Norah A Terrault(M Lange MD); (M Lange, C Katzenstein BA, T Worthington BSBA, N Rodriguez BA, K Sigel MD); (J Rios MD); (C Carroll MD); (R Meislin MD, Prof R Sperling MD); (P Argiriadi MD, S Rosberger MD); (E Rosenbluth MD, Prof N A Terrault MD); (T Kushner MD).

Tatyana Kushner(M Lange MD); (M Lange, C Katzenstein BA, T Worthington BSBA, N Rodriguez BA, K Sigel MD); (J Rios MD); (C Carroll MD); (R Meislin MD, Prof R Sperling MD); (P Argiriadi MD, S Rosberger MD); (E Rosenbluth MD, Prof N A Terrault MD); (T Kushner MD).

Funding

Nonalcoholic fatty liver disease, associated lipidomic changes, and preeclampsia riskK23HL163486 · NHLBI · WEILL MEDICAL COLL OF CORNELL UNIV · PI Tatyana Kushner · 2023 to 2026

$764k

NHLBI NIH HHS K23 HL163486

6 · The paper itself

Abstract

Background: Pregnancies affected by metabolic dysfunction-associated steatotic liver disease (MASLD) have tripled over the past decade. However, tools to assess MASLD in pregnancy are limited to ultrasound, which has shown poor reproducibility and does not provide quantitative data. Current guidelines for non-pregnant adults recommend the use of vibration-controlled transient elastography (VCTE) with controlled attenuation parameter (CAP) for staging and monitoring of liver disease. Given the limitations of ultrasound and the scarcity of data on use of VCTE in pregnancy, we evaluated the use of VCTE to determine the prevalence of MASLD in a pregnant population. Also, we determined the association between increased VCTE-derived CAP scores and adverse pregnancy outcomes. Methods: Pregnant individuals with no history of liver disease presenting for routine prenatal care were followed up throughout pregnancy and had VCTE-derived CAP assessments at 24-32 weeks of gestation. Postpartum VCTE-derived CAP assessments were also obtained. Multivariable logistic regression was performed to evaluate for predictors of liver steatosis (CAP) and liver stiffness (liver stiffness measurement [LSM]) and association with adverse pregnancy outcomes. Findings: 247 pregnant individuals (mean age 30·0 years [SD 6·0]; mean pre-pregnancy BMI 30 kg/m² [SD 6·1]) had VCTE assessments during pregnancy. The prevalence of MASLD was 11% (95% CI 7-15%) based on VCTE-derived CAP and evidence of cardiometabolic disease. On multivariable analyses, pre-pregnancy BMI was a predictor of increased CAP scores (odds ratio [OR] 1·13, 95% CI 1·05-1·22), whereas polycystic ovary syndrome was a predictor of liver stiffness (4·79, 1·11-20·65). Increased CAP scores were associated with the development of intrahepatic cholestasis of pregnancy (OR 12·07, 95% CI 1·97-73·87) and LSM with large for gestational age (8·33, 1·02-67·87). Of those with postpartum follow-up (n=41), 24 (59%) individuals had an increase in postpartum CAP scores by at least 10%. Interpretation: We found a high prevalence of MASLD in pregnancy that might not have otherwise been diagnosed. Pre-pregnancy BMI was the strongest predictor of liver steatosis and polycystic ovary syndrome for liver stiffness. Increased VCTE-derived CAP assessment results were associated with certain adverse pregnancy outcomes; however, this result should be interpreted with caution given the small sample size. VCTE-derived CAP assessment could be a useful non-invasive bedside tool to diagnose and assess liver disease in the obstetric context. The prognostic value of VCTE-derived CAP requires further investigation. Funding: National Institutes of Health-The National Heart, Lung, and Blood Institute, and Irma T Hirschl Monique Weill-Caulier Trust.

Identifiers

PMID41737674

DOI10.1016/j.lanogw.2025.100056

PMCPMC12927650

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.