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Postpartum may be a risk factor for biochemical flares in patients with primary biliary cholangitis: A single-center

Yi Wei¹, Yansong Huang¹, Xu Wang¹

¹Department of Rheumatology and Clinical Immunology, Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, National Clinical Research Center for Dermatologic and Immunologic Diseases, 1 Shuaifuyuan Hutong, Dongcheng District, Beijing, 100730, China.

Clinical Rheumatology

|July 16, 2025

Abstract

Background And Aims:

Pregnancy and fetal outcomes in patients with primary biliary cholangitis (PBC) have garnered insufficient attention due to relatively rare in women of reproductive age. In this study, intricate relationship between PBC and pregnancy were investigated.

Methods:

Twenty pregnant patients with PBC under long-term follow-up in Peking Union Medical College Hospital were enrolled, which pregnancy and fetal outcomes were retrospectively analyzed.

Results:

Among the 28 pregnancies, 5 (17.9%) resulted in miscarriages, whereas 23 were live births (82.1%, including 21 full-term and two premature births). Notably, no post-mature births or stillbirths occurred. Adverse maternal events were observed in 6 cases (6/28, 21.4%), and adverse postpartum events occurred in 3 cases (3/28, 10.7%). Most patients with PBC (7/10, 70%) maintained relatively stable biochemical measures during pregnancy. However, up to 60% (6/10) of the patients experienced biochemical flares within the first 6 months postpartum. 4 patients continued to take ursodeoxycholic acid (UDCA) during pregnancy without encountering any adverse maternal or infant outcomes.

Conclusions:

Most patients with PBC (70%) were able to maintain stable biochemical parameters during pregnancy, with good maternal and infant outcomes. Nevertheless, 60% of the patients with PBC experienced biochemical flares within the first 6 months postpartum, so close monitoring is necessary. UDCA treatment appears to be safe during pregnancy. Key Points • This retrospective study focuses on peripartum safety in reproductive-age patients with PBC during pregnancy. • Although most patients with PBC could maintain biochemical stability during pregnancy, a significant number of patients experienced biochemical flares within the first 6 months postpartum. • UDCA treatment appears to be safe during pregnancy in patients with PBC.

Keywords:

Flare Pregnancy Primary biliary cholangitis Ursodeoxycholic acid

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