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Supplemental Figure S1. Flowchart of the study population

Supplemental Figure S2. Timeline for the Study data collection

Supplemental Figure S3. Adjusted odd ratios (95% confidence intervals) of insulin- requiring gestational diabetes according to the presence of metabolic syndrome (MetS) and fatty liver index (FLI) category. Subjects with a FLI <30 and no MetS were analyzed as a

329,675

Women with delivery between 2011 and 2015 and who had undergone a health examination

within 52 weeks before pregnancy

-2,303 subjects were excluded having diabetes mellitus before pregnancy -1,278 subjects with fasting blood glucose

126 mg/dl were excluded.

-4,570 subjects were excluded with missing data on at least one variable

-6,501 subjects with a history of viral hepatitis, autoimmune hepatitis or other forms of chronic liver disease

were excluded

-6,928 subjects with excessive alcohol use were excluded

n = 308,095

Subjects eligible for inclusion

Delivery (2011-2015) 52weeks before

conception Conception

280 days

Gestational diabetes (yes/no)

Median time between evaluation period and delivery: 1.26±0.29 years Health examination

: Assessment of NAFLD

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reference group. Adjusted for age, smoking, alcohol drinking, regular exercise, income status, fasting blood glucose, and dyslipidemia.

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