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Guy’s and St Thomas’ researchers find treatment for liver condition in pregnancy reduces risk of premature labour by 40 per cent

Researchers from King’s College London and Guy’s and St Thomas’ NHS Foundation Trust have found that a treatment for a liver disorder during pregnancy significantly reduces the chance of women going into spontaneous premature labour.

Overall, prescribing ursodeoxycholic acid (UDCA) to women with intrahepatic cholestasis during their pregnancy reduces the risk of going into labour before 37 week by more than 40 per cent, especially if they are pregnant with a single baby. 

ICP is a potentially serious liver disorder which can develop during pregnancy when bile acids do not flow properly from the liver to the gut to help digest food but instead build up in the body.

It is known to increase rates of pregnancy complications including premature birth (both spontaneous and clinician-initiated), neonatal unit admission and, for women with the most severe disease, stillbirth. It is the most common pregnancy-related liver condition; affecting 

around 5,500 women each year in the UK. It is most prevalent in South Asian and Latin American women. Spontaneous premature birth affects more than one in 10 women with ICP.

Although UDCA is the most commonly used treatment for managing the illness, before this research study there was no consensus as to its benefit for women or their babies, with the largest study of its use not reporting benefit.

Primary researcher Dr Caroline Ovadia and collaborators analysed data for over 7,000 women from across the world to explore the benefits of UDCA on ICP in preventing premature and stillbirths. 

The study also demonstrated that UDCA treatment has the greatest benefit for women with more severe ICP (higher bile acid concentrations), who are therefore at higher risk of spontaneous premature birth.

Lizzie Whitcombe, who was prescribed UDCA during pregnancy, said: “I was 20-weeks pregnant and I was having trouble sleeping and suffering from sleep deprivation. 

“My legs and arms were itching. When I googled my symptoms, I was horrified when I heard about the risk of stillbirth and meconium staining. I realised I potentially had ICP. 

“My doctor prescribed UDCA. It made a real difference to my pregnancy. As soon as I started taking it, I noticed a difference. In a few days my sleep was so much better. I took it through to the end of my pregnancy. Alexander arrived only ten days early in March.

“Knowing that UDCA reduces the chance of a spontaneous premature birth, it would definitely be something I would choose to take again. 

“You want to be able to carry the baby as long as possible. And the risk of having a premature baby is very stressful. The benefits of carrying a baby to full-term are huge.”

Jane Brewin, CEO of Tommy’s which co-funded this research, said: “With 60,000 babies born prematurely in the UK each year, and mothers with ICP facing higher risks, this new study is an important step in making pregnancy safer for vulnerable families. 

“Professor Williamson’s team put this cutting-edge research into practice at Tommy’s specialist pregnancy clinics, but everyone should be entitled to the best possible care for themselves and their babies, so we hope this drug can become widely available to improve support for all those on difficult pregnancy journeys.”

The research was funded by Tommy’s, Wellcome Trust, ICP Support and the National Institute for Health Research (NIHR) Biomedical Research Centre at Guy’s and St Thomas’ NHS Foundation Trust and King’s College London.

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