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Poster Session 1

Category: Physiology/Endocrinology

Poster Session 1

(133) Individual bile acid trends in cholestasis of pregnancy

Wednesday, February 11, 2026

10:30 AM - 12:00 PM

Submitting Author and Presenting Author(s)

Anne M. Ambia, MD

Assistant Professor
University of Texas Southwestern Medical Center
Dallas, Texas, United States

Coauthor(s)

JM

Jeffrey McDonald, PhD

Professor
University of Texas Southwestern
Dallas, Texas, United States
Yevgenia Y. Fomina, MD

MFM Fellow
University of Texas Southwestern
university of Texas Southwestern, Texas, United States
TH

Tamia Harris-Tryon, MD, PhD

University of Texas Southwestern
Dallas, Texas, United States
Andrea Rizkallah, MD

Resident
University of Texas Southwestern
Dallas, Texas, United States
CW

C. Edward Wells, MD

University of Texas Southwestern Medical Center
Dallas, Texas, United States
Catherine Y. Spong, MD

Professor and Chair
University of Texas Southwestern Medical Center
Dallas, Texas, United States
DM

Donald D. McIntire, PhD

University of Texas Southwestern Medical Center
Dallas, Texas, United States
David B. Nelson, MD (he/him/his)

Associate Professor and Division Chief
University of Texas Southwestern Medical Center
Dallas, Texas, United States

Objective:
Intrahepatic cholestasis of pregnancy (ICP) is characterized by elevated total bile acids (BA) as a disease unique to pregnancy with adverse perinatal effect. We have previously established that glycol and tauro conjugated BA levels were increased in ICP. There is a paucity of information on changes in these individual BA levels over time. We aimed to measure individual BAs serially in those with ICP to observe potential treatment effect of ursodiol.

Study Design:
This was a prospective, observational cohort study of pregnant individuals with ICP(total BA were ≥10 mmol/L using a quantitative enzymatic assay) from Feb 2022 to Aug 2023 in a single academic center. At the time of initial evaluation, a blood sample was collected for analysis of individual BAs. A second sampling was performed at 35-38 weeks at least 2 weeks after the initial analysis. Extraction of BAs were performed through liquid chromatography mass spectrometry methods. Estimations are handled through the model with linear contrasts. P values and confidence intervals are adjusted for multiple comparisons through the Tukey-Kramer method.

Results:

There were 29 individuals with ICP. The mean gestational age at initial and subsequent sampling was 35.2 ± 3.8 and 36.5 ± 1.2 weeks. The mean total BA was 40±41.6 at initial sampling and decreased to 26.2±29.5 at subsequent sampling following treatment. When comparing serial samples in those with ICP, a statistically significant decrease in levels of taurocholic (P< 0.01), taurochenodeoxycholic acid (P< 0.001), and taurolambdamuricholic acid (P< 0.001) were noted. Glycolithocholic acid was noted to significantly increase from the initial to the subsequent sampling (P< 0.001) Table.

Conclusion:
Data on sequentially measured individual BA profiles in those with ICP demonstrates overall decrease in total BAs. Importantly, significant decreases in several tauro-conjugated BAs with ursodiol treatment were identified whereas glycolithocholic acid was noted to significantly increase. Understanding the specific BA profile of ICP patients receiving treatment may inform future management strategies.