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Various maternal and pregnancy\u2010related factors have also been implicated in the development of MAFLD, but human studies remain scarce.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and methods<\/jats:title><jats:p>Comprehensive data of 460 overweight or obese children aged 2\u201316\u2009years were collected and combined with data on selected maternal and pregnancy\u2010related factors for a case\u2013control study. MALFD was defined as alanine aminotransferase &gt;2\u00d7 upper limit of normal. Children with and without MAFLD were compared regarding to the study variables and multivariable regression analysis was utilized.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Median age of the study children was 11.8 (quartiles 9.1\u201314.2) years; 44% were girls and 17.8% had MAFLD. Children with MAFLD were older (12.7 vs. 11.6\u2009years, <jats:italic>p<\/jats:italic>\u2009=\u20090.002), while the groups did not differ age\u2010standardized body mass index (BMI\u2010SDS) or gender. Factors associated with MAFLD in a multivariable model considering also the offspring's present BMI\u2010SDS, sex, and maternal prepregnancy overweight, were child's older age (odds ratio [OR] 1.16, 95% confidence interval [CI]: 1.06\u20131.28), maternal gestational smoking (OR 2.01, 95% CI: 1.16\u20133.47), gestational hypertension (OR 3.44, 95% CI: 1.08\u201311.0) and pre\u2010eclampsia (OR 2.93, 95% CI: 1.15\u20137.45). There was no significant association between MAFLD and maternal BMI, birth anthropometrics or perinatal complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Maternal smoking, gestational hypertension and pre\u2010eclampsia were associated with MAFLD among overweight or obese children. Further prospective studies are needed to verify causal relationships.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.14816","type":"journal-article","created":{"date-parts":[[2024,3,4]],"date-time":"2024-03-04T07:18:47Z","timestamp":1709536727000},"page":"1183-1191","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Maternal gestational hypertension, smoking and pre\u2010eclampsia are associated with metabolic dysfunction\u2010associated fatty liver disease in overweight offspring"],"prefix":"10.1111","volume":"103","author":[{"given":"Hanna","family":"de Ruyter","sequence":"first","affiliation":[{"name":"Tampere Center for Child, Adolescent and Maternal Health Research Tampere University and Tampere University Hospital, Wellbeing Services County of Pirkanmaa  Tampere 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