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Poster Session 4

Category: Medical/Surgical/Diseases/Complications

Poster Session 4

(1218) Pregnancy Outcomes in Primary Biliary Cholangitis and Primary Sclerosing Cholangitis: A National Cohort Study

Thursday, February 12, 2026

3:30 PM - 5:00 PM

Submitting Author and Presenting Author(s)

Priyanka Gaur, MD, MPH

MFM Fellow
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Weill Cornell Medicine
New York, New York, United States

Coauthor(s)

TK

Tatyana Kushner, MD, MSCE

Associate Professor
Tatyana Kushner
New York, New York, United States
EL

Emma J. Leipsner, BS

Weill Cornell Medical College
Philadelphia, Pennsylvania, United States
KJ

Kate Johnson, BA

Weill Cornell Medical College
New York, New York, United States

Objective:
Primary sclerosing cholangitis (PSC) and primary biliary cholangitis (PBC) are rare, cholestatic liver diseases. Current understanding of how these diseases affect pregnancy is limited, and counseling is often extrapolated from intrahepatic cholestasis of pregnancy (ICP). We leveraged a large, national dataset to evaluate the independent influence of PBC and PSC on pregnancy outcomes.

Study Design:
We performed a population-based retrospective study of pregnant persons ages 12-55 from 2000-2025 using the TriNetX research network with electronic health record data from 106 U.S. health care organizations. A PSC and PBC pregnant cohort were compared to a non-PSC and non-PBC pregnant cohort, respectively. Primary outcomes were ICP, preterm delivery, postpartum hemorrhage, preeclampsia, gestational diabetes, cesarean section, fetal growth restriction, and stillbirth. A 1:1 propensity score match (PSM) balanced demographics and comorbid conditions, and multivariable logistic regression models were applied.

Results:
We identified 5,070,078 pregnant participants of which 480 (0.009%) had PBC and 292 (0.006%) had PSC (Table 1). Nearly 40% of both PBC and PSC cohorts were prescribed ursodeoxycholic acid. PBC patients were on average older and more likely to have metabolic risk factors and develop advanced liver disease within 1 year of pregnancy (all p < 0.05). PSC patients were more likely to have inflammatory bowel disease (p < 0.001). After PSM, those with PSC had increased odds of ICP compared to those without PSC (aOR 3.4, 95% CI 1.6-7.0) (Figure 1). There were no significant differences in outcomes among those with PBC compared to those without PBC. The occurrence of stillbirth was too low to calculate.

Conclusion:
Pregnancy outcomes in patients with PBC and PSC are overall favorable. Pregnant individuals with PBC and PSC had similar risk profiles compared to unaffected pregnancies, apart from a significantly increased risk of ICP in the PSC cohort. These findings support the use of ursodeoxycholic acid and antenatal surveillance in pregnancy given that the risks appear most associated with ICP.