Children born with low birth weight or small for gestational age may face up to a fourfold increased risk of developing pediatric-onset metabolic dysfunction–associated steatotic liver disease and progressive liver disease, according to a recent study.

In the nationwide case-control study from Sweden, published in JAMA Network Open, investigators explored the association between perinatal conditions and the development of metabolic dysfunction–associated steatotic liver disease (MASLD) in patients aged 25 years or younger. The study included 165 young patients with biopsy-confirmed MASLD and 717 matched controls. 

The analysis revealed an association between low birth weight and an increased risk of pediatric-onset MASLD and progressive liver disease, such as fibrosis or cirrhosis. Patients with low birth weight had a fourfold increased risk of MASLD (adjusted odds ratio [OR] = 4.05, 95% confidence interval [CI] = 1.85–8.88), and those born small for gestational age (SGA) had a threefold increased risk (adjusted OR = 3.36, 95% CI = 2.00–5.64).

The investigaors found that patients born with a weight under 2,500 g had over four times the risk of developing MASLD compared with those with normal birth weight (adjusted OR = 4.05, 95% CI = 1.85–8.88). The study indicated that those born small for gestational age (below the 10th percentile) had more than triple the likelihood of developing MASLD (adjusted OR = 3.36, 95% CI = 2.00–5.64).

The invesitgators showed that patients with low birth weight had approximately six times higher risk of developing progressive liver disease, such as fibrosis or cirrhosis (adjusted OR = 6.03, 95% CI = 1.66–21.87). Progressive liver disease was also more common in patients born SGA (adjusted OR = 4.90, 95% CI = 2.15–11.14) or with low birth weight (adjusted OR = 6.03, 95% CI = 1.66–21.87). 

Additionally, patients born small for gestational age had nearly five times the risk of developing progressive liver disease, including conditions like fibrosis or cirrhosis (adjusted OR = 4.90, 95% CI = 2.15–11.14). The study found no significant link between high birth weight (≥ 4,000 g) and the risk of developing MASLD, with an adjusted OR of 0.64 (95% CI = 0.38–1.08).

No significant association was found between high birth weight and MASLD risk. The findings suggested that newborns with low birth weight or those born SGA may be at higher risk of developing MASLD and its progression. 

Full disclosures can be found in the published study.