A large national study offers reassuring news for people with primary biliary cholangitis (PBC) who want to build their families, suggesting that most patients have favorable pregnancy outcomes similar to those without liver disease.
The research, presented at American Association for the Study of Liver Disease (AASLD)’s annual liver meeting, explored how PBC and another rare cholestatic liver disease, primary sclerosing cholangitis (PSC), affect pregnancy risks. This area has previously been poorly understood.
Learn more about PBC prognosis
Using data from more than 5 million pregnancies in the TriNetX research network between 2005 and 2025, the researchers identified 480 people with PBC and 292 with PSC who were pregnant. They then compared each group to matched pregnant individuals without these liver conditions using propensity-score matching to control for differences such as age, comorbidities and race.
Before adjusting for confounders, the team found that people with PBC were more likely to have preterm delivery, preeclampsia and intrahepatic cholestasis of pregnancy (ICP) compared with those without PBC. However, after matching for baseline differences, none of these outcomes remained statistically significant. This suggests that while PBC may initially appear linked to higher pregnancy risk, the increased rates may be largely explained by other health or demographic factors.
The study also found that individuals with PBC were more likely to have preexisting hypertension or diabetes than those with PSC. No significant differences in preterm birth or preeclampsia risk were observed after matching in either the PBC or PSC groups.
The authors noted that these findings indicate overall reassuring pregnancy outcomes for people with PBC and PSC. While vigilant monitoring and collaboration between hepatology and obstetric teams remain important, the data suggest that most people with these liver conditions can anticipate safe and successful pregnancies. The authors concluded that continued antenatal surveillance and consideration of ursodeoxycholic acid therapy may still be appropriate to manage cholestasis symptoms and support maternal and fetal health.
Sign up here to get the latest news, perspectives, and information about PBC sent directly to your inbox. Registration is free and only takes a minute.
