Low and High Birth Weights Are Risk Factors for Nonalcoholic Fatty Liver Disease in Children

Kimberly P. Newton, Haruna S. Feldman, Christina D. Chambers, Laura Wilson, Cynthia Behling, Jeanne M. Clark, Jean P. Molleston, Naga Chalasani, Arun J. Sanyal, Mark H. Fishbein, Joel E. Lavine, Jeffrey B. Schwimmer*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

86 Scopus citations


Objectives To examine the distribution of birth weight in children with nonalcoholic fatty liver disease (NAFLD) compared with the general US population, and to investigate the relationship between birth weight and severity of NAFLD. Study design A multicenter, cross-sectional study of children with biopsy-proven NAFLD enrolled in the Nonalcoholic Steatohepatitis Clinical Research Network Database. Birth weight was categorized as low birth weight (LBW), normal birth weight (NBW), or high birth weight (HBW) and compared with the birth weight distribution in the general US population. The severity of liver histology was assessed by birth weight category. Results Children with NAFLD (n = 538) had overrepresentation of both LBW and HBW compared with the general US population (LBW, 9.3%; NBW, 75.8%; HBW, 14.9% vs LBW, 6.1%; NBW, 83.5%; HBW 10.5%; P <.0001). Children with HBW had significantly greater odds of having more severe steatosis (OR, 1.82, 95% CI. 1.15-2.88) and nonalcoholic steatohepatitis (OR, 2.03; 95% CI, 1.21-3.40) compared with children with NBW. In addition, children with NAFLD and LBW had significantly greater odds of having advanced fibrosis (OR, 2.23; 95% CI, 1.08-4.62). Conclusion Birth weight involves maternal and in utero factors that may have long-lasting consequences. Children with both LBW and HBW may be at increased risk for developing NAFLD. Among children with NAFLD, those with LBW or HBW appear to be at increased risk for more severe disease.

Original languageEnglish (US)
Pages (from-to)141-146.e1
Journaljournal of pediatrics
StatePublished - Aug 1 2017


  • birth weight
  • children
  • epidemiology
  • nonalcoholic fatty liver disease
  • nonalcoholic steatohepatitis
  • obesity

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health


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