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Intrahepatic Cholestasis of PregnancyBAPPNCT07428226

Serum Bile Acid Profiles in Patients With Intrahepatic Cholestasis of Pregnancy

An observational study of Intrahepatic Cholestasis of Pregnancy, run by Jena University Hospital at 1 site in Germany.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

The goal of this observational study is to learn if analyzing bile acid patterns can help predict dangerous complications in pregnant women with intrahepatic cholestasis of pregnancy (ICP), a liver condition that can affect the baby. Read more about this study

Who is it for?
Ages 18 to 45 years, women onlyHealthy volunteers can take part
Conditions the study is for
Intrahepatic Cholestasis of Pregnancy
How many people
74 participants
Where
1 siteGermany
Study dates
1 Jul 2024to 31 Dec 2027
Phase
Observational
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 45 years
  • Women only
  • Healthy volunteers accepted
  • Adult

Study population: Group 1: Participants in this group are pregnant women diagnosed with or suspected of having ICP who are being treated at the Clinic for Obstetrics, University Hospital Jena, as part of routine clinical care. Group 2: Participants in this group are healthy pregnant women without ICP who are receiving routine prenatal care at the Clinic for Obstetrics, University Hospital Jena. Group 3: Participants in this group are healthy, non-pregnant female volunteers participating in the study independently of the clinical care setting.

Who may be able to join

  • Minimum age of 18 years
  • Written informed consent
  • Pregnant patients with suspected ICP
  • Pregnant patients with confirmed ICP
  • Pregnant patients with elevated total bile acids (>14 µmol/ml)
  • Pregnant patients with elevated liver enzymes
Show all 16Show fewer
  • Pregnant patients that suffer from itching with elevated transaminases
  • Minimum age of 18 years
  • Confirmed pregnancy
  • Written informed consent
  • Generally considered healthy in common usage (corresponding to ASA II of the American Society of Anesthesiologists classification)
  • Minimum age of 18 years
  • Female gender
  • Pregnancy excluded
  • Written informed consent
  • Generally considered healthy in common usage (corresponding to ASA II of the American Society of Anesthesiologists classification)

Who cannot join

  • Age <18 years
  • Inability to provide informed consent
  • Signs of an acute illness (for control groups II and III)
  • Known liver, biliary, or pancreatic diseases (for control groups II and III)
  • ICP in personal or family medical history (for control groups II and III)

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Silke Große, Dr. rer. nat. contact

+493641 9-329293

silke.grosse@med.uni-jena.de

Janine Zöllkau, Dr. med. contact

janine.zoellkau@med.uni-jena.de

Germany1 site, 1 recruiting
  • Klinik für Geburtsmedizin, Universitätsklinikum Jena

    Jena, Thuringia, 07747

    Silke Große, Dr., +49 3641 9329293, silke.grosse@med.uni-jena.de

    Janine Zöllkau, Dr. med., janine.zoellkau@med.uni-jena.de

    Recruiting

Other trials in Germany

About this study

The goal of this observational study is to learn if analyzing bile acid patterns can help predict dangerous complications in pregnant women with intrahepatic cholestasis of pregnancy (ICP), a liver condition that can affect the baby. The main questions it aims to answer are:

  • Can measuring specific types of bile acids (particularly taurine-conjugated versus glycine-conjugated bile acids) in the mother's and baby's blood help predict the risk of stillbirth and other complications?
  • Do these bile acid patterns activate specific receptors (TGR5) that might contribute to immune problems or heart rhythm abnormalities in the baby?
  • How do bile acid patterns in the mother's stool relate to her gut bacteria and the severity of ICP?
  • Can heart rate monitoring (CTG) combined with bile acid measurements better identify high-risk pregnancies? ICP is a pregnancy-related liver condition that causes bile acids to build up in the mother's bloodstream. This can lead to serious risks for the baby, including an increased chance of stillbirth, premature birth, and heart rhythm problems. Current monitoring methods (such as heart rate monitoring and ultrasound) often don't show warning signs before complications occur.
Read more

Participants will:

  • Provide blood samples at each routine bile acid check during pregnancy and at delivery
  • Provide stool samples for analyzing gut bacteria and bile acids
  • Have their baby's umbilical cord blood collected at birth for bile acid analysis
  • Undergo standard heart rate monitoring (CTG) of the baby
  • Have ultrasound examination of the baby's heart (echocardiography) The study will compare three groups: pregnant women with ICP, healthy pregnant women, and healthy non-pregnant women. The researchers hope this information will help doctors better predict which pregnancies need more intensive monitoring and potentially prevent stillbirths and other complications in women with ICP.
Keywords
Intrahepatic Cholestasis of pregnancy, Bile acid profile
Medical subject headings
Intrahepatic Cholestasis of Pregnancy

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

Study groups in NCT07428226
Study groupRoleWhat they receive
Pregnant ICP patientsDiagnosis or suspicion of an ICP according to Hagenbeck et al. 2021
Healthy pregnant controlsHealthy patients with a confirmed pregnancy
Healthy non-pregnant controlsHealthy woman which are not pregnant

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. bile acid profile

    Qualitative and quantitative bile acid profile in serum of mother and infant (umbilical cord blood)

    Measured: Pregnant women: from inclusion to delivery; Non-pregnant female volunteers: at inclusion

Secondary outcomes (3)
  1. TGR-5 activity

    TGR5 activation by immunosuppressive bile acids calculated according to published protocols (Leonhardt et al. 2021)

    Measured: Pregnant women: from inclusion to delivery; Non-pregnant female volunteers: at inclusion

  2. bile acid profile in stool

    The bile acid profile in stool is an exploratory outcome measure that examines the composition and concentration of various bile acids in stool samples.

    Measured: Pregnant women: from inclusion to delivery; Non-pregnant female volunteers: at inclusion

  3. materno-fetal bile acid transfer rate (bile acid profile)

    The maternal-fetal bile acid transfer rate describes the extent and efficiency with which bile acids pass from the mother through the placenta into the fetal circulation (placental permeability).

    Measured: Pregnant women: from inclusion to delivery; Non-pregnant female volunteers: at inclusion

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted23 Feb 2026
  2. Study start1 Jul 2024
  3. Primary completion31 Dec 2026 (estimated)
  4. Study completion31 Dec 2027 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Case-control
Time perspective
Prospective
Enrolment
74 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07428226
Sponsor's protocol ID
Reg.-Nr.: 2023-2917-Material
Acronym
BAPP
Status last verified
Feb 2026
First submitted
3 Feb 2026
Last updated
23 Feb 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided: * The data concerns a vulnerable population (pregnant individuals and their newborns), which is why personal information is treated with particular sensitivity. * The local data protection policy must be observed. * In scientific cooperation, a release is conceivable after careful review and in accordance with legal, ethical, and organizational requirements.

Publications

  • Hagenbeck C, Hamza A, Kehl S, Maul H, Lammert F, Keitel V, Hutten MC, Pecks U. Management of Intrahepatic Cholestasis of Pregnancy: Recommendations of the Working Group on Obstetrics and Prenatal Medicine - Section on Maternal Disorders. Geburtshilfe Frauenheilkd. 2021 Aug;81(8):922-939. doi: 10.1055/a-1386-3912. Epub 2021 Aug 9.

    PubMed 34393256
  • Shao Y, Yao Z, Lu J, Li H, Wu W, Ding M. [Change of heart rate power spectrum and its association with sudden death in the fetuses of rats with intrahepatic cholestasis of pregnancy]. Sheng Wu Yi Xue Gong Cheng Xue Za Zhi. 2007 Dec;24(6):1215-9. Chinese.

    PubMed 18232463
  • Vasavan T, Deepak S, Jayawardane IA, Lucchini M, Martin C, Geenes V, Yang J, Lovgren-Sandblom A, Seed PT, Chambers J, Stone S, Kurlak L, Dixon PH, Marschall HU, Gorelik J, Chappell L, Loughna P, Thornton J, Pipkin FB, Hayes-Gill B, Fifer WP, Williamson C. Fetal cardiac dysfunction in intrahepatic cholestasis of pregnancy is associated with elevated serum bile acid concentrations. J Hepatol. 2021 May;74(5):1087-1096. doi: 10.1016/j.jhep.2020.11.038. Epub 2020 Dec 1.

    PubMed 33276032
  • Al Inizi S, Gupta R, Gale A. Fetal tachyarrhythmia with atrial flutter in obstetric cholestasis. Int J Gynaecol Obstet. 2006 Apr;93(1):53-4. doi: 10.1016/j.ijgo.2005.12.030. Epub 2006 Mar 9. No abstract available.

    PubMed 16527280
  • Katsidzira L, Ocvirk S, Wilson A, Li J, Mahachi CB, Soni D, DeLany J, Nicholson JK, Zoetendal EG, O'Keefe SJD. Differences in Fecal Gut Microbiota, Short-Chain Fatty Acids and Bile Acids Link Colorectal Cancer Risk to Dietary Changes Associated with Urbanization Among Zimbabweans. Nutr Cancer. 2019;71(8):1313-1324. doi: 10.1080/01635581.2019.1602659. Epub 2019 Apr 22.

    PubMed 31007075
  • Li X, Xie H, Chao JJ, Jia YH, Zuo J, An YP, Bao YR, Jiang X, Ying H. Profiles and integration of the gut microbiome and fecal metabolites in severe intrahepatic cholestasis of pregnancy. BMC Microbiol. 2023 Oct 3;23(1):282. doi: 10.1186/s12866-023-02983-x.

    PubMed 37784030
  • Staley C, Weingarden AR, Khoruts A, Sadowsky MJ. Interaction of gut microbiota with bile acid metabolism and its influence on disease states. Appl Microbiol Biotechnol. 2017 Jan;101(1):47-64. doi: 10.1007/s00253-016-8006-6. Epub 2016 Nov 25.

    PubMed 27888332
  • Wahlstrom A, Sayin SI, Marschall HU, Backhed F. Intestinal Crosstalk between Bile Acids and Microbiota and Its Impact on Host Metabolism. Cell Metab. 2016 Jul 12;24(1):41-50. doi: 10.1016/j.cmet.2016.05.005. Epub 2016 Jun 16.

    PubMed 27320064
  • Lin Z, Wu J, Wang J, Levesque CL, Ma X. Dietary Lactobacillus reuteri prevent from inflammation mediated apoptosis of liver via improving intestinal microbiota and bile acid metabolism. Food Chem. 2023 Mar 15;404(Pt B):134643. doi: 10.1016/j.foodchem.2022.134643. Epub 2022 Oct 18.

    PubMed 36283304
  • Martinez-Gili L, Pechlivanis A, McDonald JAK, Begum S, Badrock J, Dyson JK, Jones R, Hirschfield G, Ryder SD, Sandford R, Rushbrook S, Thorburn D, Taylor-Robinson SD, Crossey MME, Marchesi JR, Mells G, Holmes E, Jones D. Bacterial and metabolic phenotypes associated with inadequate response to ursodeoxycholic acid treatment in primary biliary cholangitis. Gut Microbes. 2023 Jan-Dec;15(1):2208501. doi: 10.1080/19490976.2023.2208501.

    PubMed 37191344
  • Zhang X, Han S, Jiang X, Duan S, Gao Y, Ding J, Li X, Sun B, Hu X, Zhang X, Zhang W. Comparative analysis of bile metabolic profile in patients with biliary obstruction complicated by Clonorchis sinensis infection. Front Cell Infect Microbiol. 2023 Sep 12;13:1254016. doi: 10.3389/fcimb.2023.1254016. eCollection 2023.

    PubMed 37868349
  • Ryan PM, Stanton C, Caplice NM. Bile acids at the cross-roads of gut microbiome-host cardiometabolic interactions. Diabetol Metab Syndr. 2017 Dec 28;9:102. doi: 10.1186/s13098-017-0299-9. eCollection 2017.

    PubMed 29299069
  • Ridlon JM, Kang DJ, Hylemon PB, Bajaj JS. Bile acids and the gut microbiome. Curr Opin Gastroenterol. 2014 May;30(3):332-8. doi: 10.1097/MOG.0000000000000057.

    PubMed 24625896
  • Klinke P, Kurtz, Silbernagel (Hrsg.). Physiologie. In: Klinke, editor. Physiologie: Thieme; 2010. p. 471, 5.

  • Leonhardt J, Haider RS, Sponholz C, Leonhardt S, Drube J, Spengler K, Mihaylov D, Neugebauer S, Kiehntopf M, Lambert NA, Kortgen A, Bruns T, Tacke F, Hoffmann C, Bauer M, Heller R. Circulating Bile Acids in Liver Failure Activate TGR5 and Induce Monocyte Dysfunction. Cell Mol Gastroenterol Hepatol. 2021;12(1):25-40. doi: 10.1016/j.jcmgh.2021.01.011. Epub 2021 Feb 2.

    PubMed 33545429

Questions about this trial

What is this clinical trial studying?

An observational study of Intrahepatic Cholestasis of Pregnancy, run by Jena University Hospital at 1 site in Germany.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 16 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 23 Feb 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Germany. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Silke Große, Dr. rer. nat. (+493641 9-329293, silke.grosse@med.uni-jena.de), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

bile acid profile (time frame: Pregnant women: from inclusion to delivery; Non-pregnant female volunteers: at inclusion). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT07428226, which also lists 30 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 23 Feb 2026.

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