Evidence mapPaperPMID 41949636Full record

ReviewArchives of gynecology and obstetrics2026

Intrahepatic cholestasis of pregnancy and offspring neurodevelopment: bile acid-mediated mechanisms and long-term neurodevelopmental outcomes.

Siyu Dai, Hao Zhao, Yupei Xie, Qian Chen, Qiuhe Chen, Yanhui Li, Dan Shan, Xi Tan, Yayi Hu

Abstract readReview
In one paragraph

Review in Archives of gynecology and obstetrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Siyu DaiDepartment of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, 610041, People's Republic of China.
Hao ZhaoDepartment of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, 610041, People's Republic of China.
Yupei XieDepartment of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, 610041, People's Republic of China.
Qian ChenDepartment of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, 610041, People's Republic of China.
Qiuhe ChenDepartment of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, 610041, People's Republic of China.
Yanhui LiDepartment of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, 610041, People's Republic of China.
Dan ShanDepartment of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, 610041, People's Republic of China.
Xi TanDepartment of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, 610041, People's Republic of China. tanxi@scu.edu.cn.
Yayi HuDepartment of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, 610041, People's Republic of China. yayihuscu@sina.com.

Funding

National Natural Science Foundation of China Youth Fund 82301924Sichuan Provincial Department of Science and Technology 23LCYJ013
6 · The paper itself

Abstract

purposeIntrahepatic cholestasis of pregnancy (ICP) is a pregnancy-specific liver disorder characterized by pruritus and elevated maternal serum total bile acids. While clinical management has focused on bile acid-based risk stratification and delivery planning to reduce perinatal risks, emerging evidence suggests possible longer-term effects on offspring neurodevelopment. This review synthesizes current epidemiologic and mechanistic evidence linking ICP with offspring neurodevelopmental outcomes.

methodsPubMed, Embase, and Web of Science were searched using controlled vocabulary and free-text terms. Relevant references were evaluated for inclusion in a stepwise approach.

resultsLarge Nordic register-based studies report associations between in utero ICP exposure and increased risks of childhood neurodevelopmental diagnoses, particularly in earlier-onset disease. Follow-up cohorts suggest altered early-life growth trajectories related to biochemical severity. Mechanistically, elevated maternal bile acids are a plausible proximal exposure. Maternal bile acid overload can disrupt placental bile acid transport and handling, alter the feto-maternal bile acid gradient, and increase fetal bile acid burden. The placenta may further convert bile acid perturbations into inflammatory, oxidative stress, endoplasmic reticulum stress, and vasoactive signals that reshape the intrauterine milieu during sensitive windows of brain development. By contrast, downstream pathways involving microglial priming, neuroinflammation, and blood-brain barrier vulnerability are supported mainly by indirect evidence and require validation in pregnancy-relevant models.

conclusionCurrent evidence supports a life-course perspective on ICP beyond established perinatal risks. Maternal bile acids and placental dysfunction provide a coherent mechanistic framework for possible neurodevelopmental effects, but pregnancy-relevant mechanistic studies and longitudinal cohorts with refined exposure assessment are still needed.

Indexed as

Bile Acids and SaltsCholestasis, IntrahepaticNeurodevelopmental DisordersPregnancy ComplicationsPrenatal Exposure Delayed EffectsFemaleHumansNeurodevelopmentPlacentaPregnancyBile Acids and SaltsIntrahepatic cholestasis of pregnancyLong-term outcomesNeurodevelopmentOffspringTotal bile acids

Identifiers

PMID41949636
PMCPMC13061807

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.