{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T10:07:32Z","timestamp":1790158052458,"version":"4.1.0"},"reference-count":125,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T00:00:00Z","timestamp":1790121600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100018617","name":"LiaoNing Revitalization Talents Program","doi-asserted-by":"publisher","award":["XLYC2412033"],"award-info":[{"award-number":["XLYC2412033"]}],"id":[{"id":"10.13039\/501100018617","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Int. J. Mol. Sci.","IJMS"],"abstract":"<jats:p>Intrahepatic cholestasis of pregnancy (ICP) is a pregnancy-specific liver disorder characterized by elevated maternal bile acid concentrations and an increased risk of adverse perinatal outcomes. Genetic susceptibility, hormonal changes, and impaired bile acid transport contribute to its development but do not fully explain the variability in disease severity and fetal outcomes. Increasing evidence suggests that gut microbiota dysbiosis and altered bile acid metabolism are associated with ICP and may participate in disease development through the gut\u2013liver\u2013placenta axis. In this review, we integrate evidence on bile acid\u2013microbiota interactions during pregnancy, ICP-associated microbial and metabolic alterations, and their possible links to placental and fetal outcomes. Human studies primarily support associations among microbial alterations, bile acid profiles, and disease severity, whereas the microbiota-mediated effects on placental function and fetal injury proposed to date are supported largely by experimental models. We further discuss potential links among gut microbial dysfunction, placental oxidative stress, fetal cardiac injury, neurodevelopmental risk, offspring metabolic susceptibility, and iatrogenic prematurity. Although ursodeoxycholic acid (UDCA) improves maternal pruritus and selected biochemical indices, its effect on major perinatal outcomes remains uncertain. Ileal bile acid transporter (IBAT) inhibitors and microbiota-targeted interventions remain investigational, with insufficient pregnancy-specific evidence regarding their efficacy and maternal\u2013fetal safety. Future studies should clarify the associated causal mechanisms and integrate metagenomic, metabolomic, and placental data to identify clinically relevant biomarkers and therapeutic targets.<\/jats:p>","DOI":"10.3390\/ijms27198481","type":"journal-article","created":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T09:20:46Z","timestamp":1790155246000},"page":"8481","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Molecular Mechanisms of the Gut\u2013Liver\u2013Placenta Axis in Intrahepatic Cholestasis of Pregnancy: Microbiota-Associated Pathogenesis and Next-Generation Therapeutic Strategies"],"prefix":"10.3390","volume":"27","author":[{"given":"Ningwei","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, The First Affiliated Hospital of China Medical University, 155 Nanjing North Street, Shenyang 110001, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-3962-8249","authenticated-orcid":false,"given":"Shuairan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, The First Affiliated Hospital of China Medical University, 155 Nanjing North Street, Shenyang 110001, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yiling","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, The First Affiliated Hospital of China Medical University, 155 Nanjing North Street, Shenyang 110001, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Jasak, K., Gajzlerska-Majewska, W., Jabiry-Zieniewicz, Z., Litwi\u0144ska-Korcz, E., Litwi\u0144ska, M., Ludwin, A., and Szpota\u0144ska-Sikorska, M. (2025). Intrahepatic Cholestasis of Pregnancy: Diagnosis, Management, and Future Directions\u2014A Review of the Literature. Diagnostics, 15.","DOI":"10.3390\/diagnostics15162002"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Piechota, J., and Jelski, W. (2020). Intrahepatic Cholestasis in Pregnancy: Review of the Literature. J. Clin. Med., 9.","DOI":"10.3390\/jcm9051361"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1016\/j.iliver.2023.11.001","article-title":"Intrahepatic Cholestasis of Pregnancy Is Associated with Increased Risk of Hepatobiliary Disease and Adverse Fetal Outcomes: A Systematic Review and Meta-Analysis","volume":"2","author":"Odutola","year":"2023","journal-title":"iLIVER"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"38946","DOI":"10.1038\/srep38946","article-title":"Downregulation of Peroxiredoxin-3 by Hydrophobic Bile Acid Induces Mitochondrial Dysfunction and Cellular Senescence in Human Trophoblasts","volume":"6","author":"Wu","year":"2016","journal-title":"Sci. Rep."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"\u00c7anga, K., El\u00fcst\u00fc, B., Bahad\u0131r, \u0130.B., \u00d6zcan, \u00dc., Erol, S.A., and \u00c7elen, \u015e. (2026). The Relationship Between Maternal Serum Afamin Levels and Intrahepatic Cholestasis of Pregnancy and Neonatal Outcomes. J. Clin. Med., 15.","DOI":"10.3390\/jcm15093241"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1007\/s13224-021-01501-1","article-title":"Serum Bile Acids in Intrahepatic Cholestasis of Pregnancy (ICP), Versus Pregnant and Nonpregnant Controls in Asian Indian Women and a Proposed Scoring to Optimize Management in ICP","volume":"72","author":"Agarwal","year":"2022","journal-title":"J. Obstet. Gynecol. India"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Xue, Z., Han, Q., Han, H., Yan, L., Ma, X., Ji, P., Wang, B., Zhang, L., Wang, L., and Liu, G. (2026). Mechanisms of Fetal Growth Restriction in Gestational Cholestasis: Role of Gut Microbiota and Placental Redox. Front. Vet. Sci., 13.","DOI":"10.3389\/fvets.2026.1815498"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Li, C., Li, N., Liu, C., and Yin, S. (2023). Causal Association between Gut Microbiota and Intrahepatic Cholestasis of Pregnancy: Mendelian Randomization Study. BMC Pregnancy Childbirth, 23.","DOI":"10.1186\/s12884-023-05889-8"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1016\/j.livres.2021.07.002","article-title":"Bile Acid Receptors and Signaling Crosstalk in the Liver, Gut and Brain","volume":"5","author":"Ferrell","year":"2021","journal-title":"Liver Res."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"817","DOI":"10.3748\/wjg.15.817","article-title":"Excretion of Biliary Compounds during Intrauterine Life","volume":"15","author":"Macias","year":"2009","journal-title":"World J. Gastroenterol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1007\/s00404-026-08411-5","article-title":"Intrahepatic Cholestasis of Pregnancy and Offspring Neurodevelopment: Bile Acid-Mediated Mechanisms and Long-Term Neurodevelopmental Outcomes","volume":"313","author":"Dai","year":"2026","journal-title":"Arch. Gynecol. Obstet."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Ovadia, C., McIlvride, S., Schoonejans, J.M., Spagou, K., G\u00f3mez-Romero, M., Smith, A., Papacleovoulou, G., Nikolova, V., Dixon, P.H., and Holmes, E. (2026). Maternal Diet-Induced Hypercholanemia Alters Gut Microbiota and Metabolome in Adult Female Western Diet-Fed Offspring. Exp. Biol. Med., 251.","DOI":"10.3389\/ebm.2026.10810"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1007\/s12072-023-10604-y","article-title":"Intrahepatic Cholestasis of Pregnancy: Insights into Pathogenesis and Advances in Omics Studies","volume":"18","author":"Tang","year":"2024","journal-title":"Hepatol. Int."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1361","DOI":"10.1080\/17474124.2021.2011211","article-title":"Research Progress in the Role of Gut Microbiota and Its Metabolites in Intrahepatic Cholestasis of Pregnancy","volume":"15","author":"Ren","year":"2021","journal-title":"Expert Rev. Gastroenterol. Hepatol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"100838","DOI":"10.1016\/j.ajogmf.2022.100838","article-title":"Intrahepatic Cholestasis of Pregnancy: A Comparison of Society for Maternal-Fetal Medicine and the Royal College of Obstetricians and Gynaecologists\u2019 Guidelines","volume":"5","author":"Horgan","year":"2023","journal-title":"Am. J. Obstet. Gynecol. MFM"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1038\/s41579-022-00805-x","article-title":"Bile Acids and the Gut Microbiota: Metabolic Interactions and Impacts on Disease","volume":"21","author":"Collins","year":"2023","journal-title":"Nat. Rev. Microbiol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"G55","DOI":"10.1152\/ajpgi.00476.2020","article-title":"Dynamics of the Enterohepatic Circulation of Bile Acids in Healthy Humans","volume":"321","author":"Stellaard","year":"2021","journal-title":"Am. J. Physiol.-Gastrointest. Liver Physiol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1955","DOI":"10.1194\/jlr.R900010-JLR200","article-title":"Bile Acids: Regulation of Synthesis","volume":"50","author":"Chiang","year":"2009","journal-title":"J. Lipid Res."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"948","DOI":"10.1124\/pr.113.008201","article-title":"Bile Acid Signaling in Metabolic Disease and Drug Therapy","volume":"66","author":"Li","year":"2014","journal-title":"Pharmacol. Rev."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1085","DOI":"10.1194\/jlr.R054114","article-title":"Intestinal Transport and Metabolism of Bile Acids","volume":"56","author":"Dawson","year":"2015","journal-title":"J. Lipid Res."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"7341","DOI":"10.3748\/wjg.v19.i42.7341","article-title":"Physiological and Molecular Biochemical Mechanisms of Bile Formation","volume":"19","author":"Reshetnyak","year":"2013","journal-title":"World J. Gastroenterol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1038\/s41392-024-01811-6","article-title":"Bile Acid Metabolism and Signaling in Health and Disease: Molecular Mechanisms and Therapeutic Targets","volume":"9","author":"Fleishman","year":"2024","journal-title":"Signal Transduct. Target Ther."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Bourgin, M., Kriaa, A., Mkaouar, H., Mariaule, V., Jablaoui, A., Maguin, E., and Rhimi, M. (2021). Bile Salt Hydrolases: At the Crossroads of Microbiota and Human Health. Microorganisms, 9.","DOI":"10.3390\/microorganisms9061122"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Chu, H., Song, X., Liu, C., Ma, T., and Cui, W. (2026). Gut Microbial Bile Salt Hydrolase as a Metabolic Gatekeeper in Digestive Homeostasis and Disease. Front. Immunol., 17.","DOI":"10.3389\/fimmu.2026.1870619"},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Wise, J.L., and Cummings, B.P. (2023). The 7-\u03b1-Dehydroxylation Pathway: An Integral Component of Gut Bacterial Bile Acid Metabolism and Potential Therapeutic Target. Front. Microbiol., 13.","DOI":"10.3389\/fmicb.2022.1093420"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"71","DOI":"10.3727\/105221618X15156018385515","article-title":"Bile Acid Metabolism in Liver Pathobiology","volume":"18","author":"Chiang","year":"2018","journal-title":"Gene Expr."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1159\/000450987","article-title":"Roles of Ileal ASBT and OST\u03b1-OST\u03b2 in Regulating Bile Acid Signaling","volume":"35","author":"Dawson","year":"2017","journal-title":"Dig. Dis."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"683","DOI":"10.1152\/physrev.00049.2019","article-title":"Molecular Physiology of Bile Acid Signaling in Health, Disease, and Aging","volume":"101","author":"Perino","year":"2021","journal-title":"Physiol. Rev."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1243","DOI":"10.1111\/apt.16602","article-title":"Review Article: Therapeutic Aspects of Bile Acid Signalling in the Gut-liver Axis","volume":"54","author":"Simbrunner","year":"2021","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1016\/j.jcmgh.2019.08.006","article-title":"Impaired Intestinal Farnesoid X Receptor Signaling in Cystic Fibrosis Mice","volume":"9","author":"Ikpa","year":"2020","journal-title":"Cell. Mol. Gastroenterol. Hepatol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"470","DOI":"10.1016\/j.cell.2012.07.008","article-title":"Host Remodeling of the Gut Microbiome and Metabolic Changes during Pregnancy","volume":"150","author":"Koren","year":"2012","journal-title":"Cell"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1038\/s41575-023-00864-2","article-title":"The Maternal Gut Microbiome in Pregnancy: Implications for the Developing Immune System","volume":"21","author":"Koren","year":"2024","journal-title":"Nat. Rev. Gastroenterol. Hepatol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"e25227","DOI":"10.1016\/j.heliyon.2024.e25227","article-title":"Regulation of PDGFR\u03b1+ Cells and ICC in Progesterone-Mediated Slow Colon Transit in Pregnant Mice","volume":"10","author":"Lu","year":"2024","journal-title":"Heliyon"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1177\/1753495X241263441","article-title":"Genetic Issues in ICP","volume":"17","author":"Williamson","year":"2024","journal-title":"Obstet. Med."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1038\/ajg.2013.406","article-title":"A Comprehensive Analysis of Common Genetic Variation Around Six Candidate Loci for Intrahepatic Cholestasis of Pregnancy","volume":"109","author":"Dixon","year":"2014","journal-title":"Am. J. Gastroenterol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"11823","DOI":"10.1038\/s41598-017-11626-x","article-title":"An Expanded Role for Heterozygous Mutations of ABCB4, ABCB11, ATP8B1, ABCC2 and TJP2 in Intrahepatic Cholestasis of Pregnancy","volume":"7","author":"Dixon","year":"2017","journal-title":"Sci. Rep."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Stygar, D., Bogielski, B., Michalczyk, K., Skrzep-Poloczek, B., Suchocka, A., Nikiel, K., Kukla, K., Wasek, R., Staniszewski, J., and Matyja, M. (2026). Cholestatic and Autoimmune Liver Diseases, Bile Duct Injury, Oxidative Stress, and Therapeutic Strategies. Front. Physiol., 17.","DOI":"10.3389\/fphys.2026.1788973"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"8186","DOI":"10.1038\/ncomms9186","article-title":"Maternal Bile Acid Transporter Deficiency Promotes Neonatal Demise","volume":"6","author":"Zhang","year":"2015","journal-title":"Nat. Commun."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"716","DOI":"10.1002\/hep.26055","article-title":"Intrahepatic Cholestasis of Pregnancy Levels of Sulfated Progesterone Metabolites Inhibit Farnesoid X Receptor Resulting in a Cholestatic Phenotype","volume":"57","author":"Papacleovoulou","year":"2013","journal-title":"Hepatology"},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Alaei Faradonbeh, F., Lastuvkova, H., Cermanova, J., Hroch, M., Nova, Z., Uher, M., Hirsova, P., Pavek, P., and Micuda, S. (2022). Multidrug Resistance-Associated Protein 2 Deficiency Aggravates Estrogen-Induced Impairment of Bile Acid Metabolomics in Rats. Front. Physiol., 13.","DOI":"10.3389\/fphys.2022.859294"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1355","DOI":"10.1016\/j.ajpath.2023.06.010","article-title":"Sex-Dependent Differences in Cholestasis","volume":"193","author":"Ismail","year":"2023","journal-title":"Am. J. Pathol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1993","DOI":"10.1002\/hep.27171","article-title":"Transcriptional Dynamics of Bile Salt Export Pump during Pregnancy: Mechanisms and Implications in Intrahepatic Cholestasis of Pregnancy","volume":"60","author":"Song","year":"2014","journal-title":"Hepatology"},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Wang, P., Yuan, P., Lin, S., Zhong, H., Zhang, X., Zhuo, Y., Li, J., Che, L., Feng, B., and Lin, Y. (2022). Maternal and Fetal Bile Acid Homeostasis Regulated by Sulfated Progesterone Metabolites through FXR Signaling Pathway in a Pregnant Sow Model. Int. J. Mol. Sci., 23.","DOI":"10.3390\/ijms23126496"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1177\/1753495X241258383","article-title":"Microbial Metabolites as a Way to Provide Crosstalk between Gut and Liver","volume":"17","author":"Ovadia","year":"2024","journal-title":"Obstet. Med."},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Li, X., Xie, H., Chao, J., Jia, Y.-H., Zuo, J., An, Y., Bao, Y.-R., Jiang, X., and Ying, H. (2023). Profiles and Integration of the Gut Microbiome and Fecal Metabolites in Severe Intrahepatic Cholestasis of Pregnancy. BMC Microbiol., 23.","DOI":"10.1186\/s12866-023-02983-x"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1305","DOI":"10.1038\/s41467-023-36981-4","article-title":"Gut Microbiota Alters Host Bile Acid Metabolism to Contribute to Intrahepatic Cholestasis of Pregnancy","volume":"14","author":"Tang","year":"2023","journal-title":"Nat. Commun."},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Donz\u00e9, F.J., Eli, N., Di Simone, N., Cavegn, B.B., and Mueller, M. (2026). The Impact of Gut Microbiome on Intrahepatic Cholestasis of Pregnancy\u2014Systematic Literature Review. Front. Med., 13.","DOI":"10.3389\/fmed.2026.1859397"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"7338","DOI":"10.3748\/wjg.v26.i46.7338","article-title":"Response of Gut Microbiota to Serum Metabolome Changes in Intrahepatic Cholestasis of Pregnant Patients","volume":"26","author":"Li","year":"2020","journal-title":"World J. Gastroenterol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"e25861","DOI":"10.1016\/j.heliyon.2024.e25861","article-title":"A Study on the Relationship between Gut Microbiota and Intrahepatic Cholestasis of Pregnancy","volume":"10","author":"Liu","year":"2024","journal-title":"Heliyon"},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Zhan, Q., Qi, X., Weng, R., Xi, F., Chen, Y., Wang, Y., Hu, W., Zhao, B., and Luo, Q. (2021). Alterations of the Human Gut Microbiota in Intrahepatic Cholestasis of Pregnancy. Front. Cell. Infect. Microbiol., 11.","DOI":"10.3389\/fcimb.2021.635680"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"e70035","DOI":"10.1002\/imt2.70035","article-title":"Single-microbe RNA Sequencing Uncovers Unexplored Specialized Metabolic Functions of Keystone Species in the Human Gut","volume":"4","author":"Shen","year":"2025","journal-title":"iMeta"},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"Li, R., Chen, X., Liu, Z., Chen, Y., Liu, C., Ye, L., Xiao, L., Yang, Z., He, J., and Wang, W.-J. (2020). Characterization of Gut Microbiota Associated with Clinical Parameters in Intrahepatic Cholestasis of Pregnancy. BMC Gastroenterol., 20.","DOI":"10.1186\/s12876-020-01510-w"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"108392","DOI":"10.1016\/j.isci.2023.108392","article-title":"Roseburia Intestinalis Relieves Intrahepatic Cholestasis of Pregnancy through Bile Acid\/FXR-FGF15 in Rats","volume":"26","author":"Sun","year":"2023","journal-title":"iScience"},{"key":"ref_54","doi-asserted-by":"crossref","unstructured":"Fang, Y., Kang, Z., Zhang, W., Xiang, Y., Cheng, X., Gui, M., and Fang, D. (2024). Core Biomarkers Analysis Benefit for Diagnosis on Human Intrahepatic Cholestasis of Pregnancy. BMC Pregnancy Childbirth, 24.","DOI":"10.1186\/s12884-024-06730-6"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"601","DOI":"10.4254\/wjh.v16.i4.601","article-title":"Expression and Clinical Significance of Short-Chain Fatty Acids in Patients with Intrahepatic Cholestasis of Pregnancy","volume":"16","author":"Ren","year":"2024","journal-title":"World J. Hepatol."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"880","DOI":"10.1111\/1471-0528.17026","article-title":"Untargeted Lipidomics Analysis in Women with Intrahepatic Cholestasis of Pregnancy: A Cross-sectional Study","volume":"129","author":"Sun","year":"2022","journal-title":"BJOG Int. J. Obstet. Gynaecol."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"117854","DOI":"10.1016\/j.cca.2024.117854","article-title":"Metabolomic Profiling of Serum and Tongue Coating of Pregnant Women with Intrahepatic Cholestasis in Pregnancy","volume":"557","author":"Zhang","year":"2024","journal-title":"Clin. Chim. Acta"},{"key":"ref_58","doi-asserted-by":"crossref","unstructured":"Liu, W., Wang, Q., Chang, J., Bhetuwal, A., Bhattarai, N., and Ni, X. (2022). Circulatory Metabolomics Reveals the Association of the Metabolites With Clinical Features in the Patients With Intrahepatic Cholestasis of Pregnancy. Front. Physiol., 13.","DOI":"10.3389\/fphys.2022.848508"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"418","DOI":"10.1039\/D2MO00305H","article-title":"The Complete Change in Bile Acids and Steroids in Systematic Metabolomics Applied to the Intrahepatic Cholestasis of Pregnancy","volume":"19","author":"Xu","year":"2023","journal-title":"Mol. Omics"},{"key":"ref_60","doi-asserted-by":"crossref","unstructured":"Dong, R., Ye, N., Zhao, S., Wang, G., Zhang, Y., Wang, T., Zou, P., Wang, J., Yao, T., and Chen, M. (2021). Studies on Novel Diagnostic and Predictive Biomarkers of Intrahepatic Cholestasis of Pregnancy Through Metabolomics and Proteomics. Front. Immunol., 12.","DOI":"10.3389\/fimmu.2021.733225"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"106008","DOI":"10.1016\/j.ebiom.2025.106008","article-title":"Longitudinal Alterations of Gut Microbiota Associated with Intrahepatic Cholestasis of Pregnancy: Results from a Large Cohort Study in China","volume":"122","author":"Shan","year":"2025","journal-title":"eBioMedicine"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"e18337","DOI":"10.1002\/advs.202518337","article-title":"Nanocellulose Alleviates Intrahepatic Cholestasis of Pregnancy via Gut Microbiota-Mediated Bile Acid Homeostasis","volume":"13","author":"Yu","year":"2026","journal-title":"Adv. Sci."},{"key":"ref_63","doi-asserted-by":"crossref","unstructured":"Lin, Q., Huang, W., Shen, W., Deng, X., Tang, Z., Chen, Z., Zhao, W., and Fan, H. (2022). Intrahepatic Cholestasis of Pregnancy Increases Inflammatory Susceptibility in Neonatal Offspring by Modulating Gut Microbiota. Front. Immunol., 13.","DOI":"10.3389\/fimmu.2022.889646"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"899","DOI":"10.1016\/S0140-6736(18)31877-4","article-title":"Association of Adverse Perinatal Outcomes of Intrahepatic Cholestasis of Pregnancy with Biochemical Markers: Results of Aggregate and Individual Patient Data Meta-Analyses","volume":"393","author":"Ovadia","year":"2019","journal-title":"Lancet"},{"key":"ref_65","doi-asserted-by":"crossref","unstructured":"Rook, M., Vargas, J., Caughey, A., Bacchetti, P., Rosenthal, P., and Bull, L. (2012). Fetal Outcomes in Pregnancies Complicated by Intrahepatic Cholestasis of Pregnancy in a Northern California Cohort. PLoS ONE, 7.","DOI":"10.1371\/journal.pone.0028343"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"853","DOI":"10.1016\/S0140-6736(18)32323-7","article-title":"Management of Intrahepatic Cholestasis in Pregnancy","volume":"393","author":"Palmer","year":"2019","journal-title":"Lancet"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"1535","DOI":"10.1007\/s00404-011-2183-4","article-title":"Alteration in Placental Expression of Bile Acids Transporters OATP1A2, OATP1B1, OATP1B3 in Intrahepatic Cholestasis of Pregnancy","volume":"285","author":"Wang","year":"2012","journal-title":"Arch. Gynecol. Obstet."},{"key":"ref_68","doi-asserted-by":"crossref","unstructured":"Ontsouka, E., Epstein, A., Kallol, S., Zaugg, J., Baumann, M., Schneider, H., and Albrecht, C. (2021). Placental Expression of Bile Acid Transporters in Intrahepatic Cholestasis of Pregnancy. Int. J. Mol. Sci., 22.","DOI":"10.3390\/ijms221910434"},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"545","DOI":"10.1016\/j.placenta.2015.02.005","article-title":"Agonist of Farnesoid X Receptor Protects against Bile Acid Induced Damage and Oxidative Stress in Mouse Placenta\u2014A Study on Maternal Cholestasis Model","volume":"36","author":"Wu","year":"2015","journal-title":"Placenta"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1016\/j.placenta.2004.10.020","article-title":"Maternal Cholestasis Induces Placental Oxidative Stress and Apoptosis. Protective Effect of Ursodeoxycholic Acid","volume":"27","author":"Perez","year":"2006","journal-title":"Placenta"},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1016\/0028-2243(91)90222-7","article-title":"Vasoconstrictive Effect of Bile Acids on Isolated Human Placental Chorionic Veins","volume":"42","author":"Cruz","year":"1991","journal-title":"Eur. J. Obstet. Gynecol. Reprod. Biol."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"1087","DOI":"10.1016\/j.jhep.2020.11.038","article-title":"Fetal Cardiac Dysfunction in Intrahepatic Cholestasis of Pregnancy Is Associated with Elevated Serum Bile Acid Concentrations","volume":"74","author":"Vasavan","year":"2021","journal-title":"J. Hepatol."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"B2","DOI":"10.1016\/j.ajog.2020.11.002","article-title":"Society for Maternal-Fetal Medicine Consult Series #53: Intrahepatic Cholestasis of Pregnancy","volume":"224","author":"Lee","year":"2021","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_74","doi-asserted-by":"crossref","unstructured":"Chen, S., Ahlqvist, V.H., Sj\u00f6qvist, H., Stephansson, O., Magnusson, C., Dalman, C., Karlsson, H., Lee, B.K., and Gardner, R.M. (2024). Maternal Intrahepatic Cholestasis of Pregnancy and Neurodevelopmental Conditions in Offspring: A Population-Based Cohort Study of 2 Million Swedish Children. PLoS Med., 21.","DOI":"10.1371\/journal.pmed.1004331"},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"10361","DOI":"10.1038\/s41598-020-67301-1","article-title":"Ursodeoxycholic Acid Improves Feto-Placental and Offspring Metabolic Outcomes in Hypercholanemic Pregnancy","volume":"10","author":"Papacleovoulou","year":"2020","journal-title":"Sci. Rep."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"3172","DOI":"10.1172\/JCI68927","article-title":"Maternal Cholestasis during Pregnancy Programs Metabolic Disease in Offspring","volume":"123","author":"Papacleovoulou","year":"2013","journal-title":"J. Clin. Investig."},{"key":"ref_77","doi-asserted-by":"crossref","unstructured":"Guner Yilmaz, B., Abali, S., Moniri, A., Kilinckaya, U., Altinbas, E., Ay, B., Karakose, B., Sahinoglu, Y., Sahinoglu, M., and Yilmaz, B. (2025). Early Metabolic Profile in Neonates with Maternal Intrahepatic Cholestasis of Pregnancy. Children, 12.","DOI":"10.3390\/children12121655"},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"243","DOI":"10.2337\/dc14-2143","article-title":"The Metabolic Profile of Intrahepatic Cholestasis of Pregnancy Is Associated With Impaired Glucose Tolerance, Dyslipidemia, and Increased Fetal Growth","volume":"38","author":"Martineau","year":"2015","journal-title":"Diabetes Care"},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"538","DOI":"10.1016\/j.jpeds.2014.09.041","article-title":"Intestinal Microbiota Development in Preterm Neonates and Effect of Perinatal Antibiotics","volume":"166","author":"Arboleya","year":"2015","journal-title":"J. Pediatr."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"639","DOI":"10.1002\/jpen.1695","article-title":"Impact of Postnatal Antibiotics and Parenteral Nutrition on the Gut Microbiota in Preterm Infants During Early Life","volume":"44","author":"Jia","year":"2020","journal-title":"J. Parenter. Enter. Nutr."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1016\/j.jogn.2017.08.009","article-title":"Systematic Review of the Effect of Enteral Feeding on Gut Microbiota in Preterm Infants","volume":"47","author":"Xu","year":"2018","journal-title":"J. Obstet. Gynecol. Neonatal Nurs."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"2183690","DOI":"10.1080\/19490976.2023.2183690","article-title":"Cholestasis Impairs Gut Microbiota Development and Bile Salt Hydrolase Activity in Preterm Neonates","volume":"15","author":"Lynch","year":"2023","journal-title":"Gut Microbes"},{"key":"ref_83","first-page":"1036","article-title":"Fecal Microbiome and Bile Acid Profiles Differ in Preterm Infants with Parenteral Nutrition-Associated Cholestasis","volume":"13","author":"Wagner","year":"2025","journal-title":"J. Clin. Transl. Hepatol."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1002\/ijgo.70161","article-title":"FIGO Guideline on Liver Disease and Pregnancy","volume":"170","author":"Nana","year":"2025","journal-title":"Int. J. Gynecol. Obstet."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"656","DOI":"10.1111\/ajo.13719","article-title":"Intrahepatic Cholestasis of Pregnancy\u2014Diagnosis and Management: A Consensus Statement of the Society of Obstetric Medicine of Australia and New Zealand (SOMANZ): Executive Summary","volume":"63","author":"Hague","year":"2023","journal-title":"Aust. N. Z. J. Obstet. Gynaecol."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1053\/jhep.2002.36088","article-title":"Ursodeoxycholic Acid in Cholestatic Liver Disease: Mechanisms of Action and Therapeutic Use Revisited","volume":"36","author":"Paumgartner","year":"2002","journal-title":"Hepatology"},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"206","DOI":"10.2174\/1389203724666230818092800","article-title":"Bile Acids as Signaling Molecules: Role of Ursodeoxycholic Acid in Cholestatic Liver Disease","volume":"25","year":"2024","journal-title":"Curr. Protein Pept. Sci."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"3895","DOI":"10.1038\/s41598-020-60821-w","article-title":"Ursodeoxycholic Acid Enriches Intestinal Bile Salt Hydrolase-Expressing Bacteroidetes in Cholestatic Pregnancy","volume":"10","author":"Ovadia","year":"2020","journal-title":"Sci. Rep."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"528","DOI":"10.1055\/a-2845-6610","article-title":"The Latest on Intrahepatic Cholestasis of Pregnancy\u2014Update 2026","volume":"86","author":"Jurk","year":"2026","journal-title":"Geburtshilfe Frauenheilkd."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"894","DOI":"10.1053\/j.gastro.2005.06.019","article-title":"Efficacy and Safety of Ursodeoxycholic Acid Versus Cholestyramine in Intrahepatic Cholestasis of Pregnancy","volume":"129","author":"Kondrackiene","year":"2005","journal-title":"Gastroenterology"},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"1399","DOI":"10.1002\/hep.20952","article-title":"Intrahepatic Cholestasis of Pregnancy: A Randomized Controlled Trial Comparing Dexamethasone and Ursodeoxycholic Acid","volume":"42","author":"Glantz","year":"2005","journal-title":"Hepatology"},{"key":"ref_92","first-page":"757","article-title":"Efficacy and Safety of Ursodeoxycholic Acid in Patients with Intrahepatic Cholestasis of Pregnancy","volume":"15","author":"Simjak","year":"2016","journal-title":"Ann. Hepatol."},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"849","DOI":"10.1016\/S0140-6736(19)31270-X","article-title":"Ursodeoxycholic Acid versus Placebo in Women with Intrahepatic Cholestasis of Pregnancy (PITCHES): A Randomised Controlled Trial","volume":"394","author":"Chappell","year":"2019","journal-title":"Lancet"},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1016\/S2468-1253(21)00074-1","article-title":"Ursodeoxycholic Acid in Intrahepatic Cholestasis of Pregnancy: A Systematic Review and Individual Participant Data Meta-Analysis","volume":"6","author":"Ovadia","year":"2021","journal-title":"Lancet Gastroenterol. Hepatol."},{"key":"ref_95","first-page":"CD000493","article-title":"Pharmacological Interventions for Treating Intrahepatic Cholestasis of Pregnancy","volume":"7","author":"Walker","year":"2020","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_96","first-page":"e32509","article-title":"Feto-Maternal Effects of Adding Rifampicin to Ursodeoxycholic Acid in the Treatment of Intrahepatic Cholestasis of Pregnancy","volume":"14","author":"Kumari","year":"2022","journal-title":"Cureus"},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1016\/j.ejogrb.2015.03.020","article-title":"Rifampicin in the Treatment of Severe Intrahepatic Cholestasis of Pregnancy","volume":"189","author":"Geenes","year":"2015","journal-title":"Eur. J. Obstet. Gynecol. Reprod. Biol."},{"key":"ref_98","first-page":"3770","article-title":"Ursodeoxycholic Acid and S-Adenosylmethionine in the Treatment of Intrahepatic Cholestasis of Pregnancy: A Multi-Centered Randomized Controlled Trial","volume":"19","author":"Zhang","year":"2015","journal-title":"Eur. Rev. Med. Pharmacol. Sci."},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"1812","DOI":"10.1111\/liv.14553","article-title":"Potential of Ileal Bile Acid Transporter Inhibition as a Therapeutic Target in Alagille Syndrome and Progressive Familial Intrahepatic Cholestasis","volume":"40","author":"Kamath","year":"2020","journal-title":"Liver Int."},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1080\/14728214.2024.2336986","article-title":"Emerging Drugs for the Treatment of Progressive Familial Intrahepatic Cholestasis: A Focus on Phase II and III Trials","volume":"29","author":"Hof","year":"2024","journal-title":"Expert Opin. Emerg. Drugs"},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"830","DOI":"10.1016\/S2468-1253(22)00093-0","article-title":"Odevixibat Treatment in Progressive Familial Intrahepatic Cholestasis: A Randomised, Placebo-Controlled, Phase 3 Trial","volume":"7","author":"Thompson","year":"2022","journal-title":"Lancet Gastroenterol. Hepatol."},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"101486","DOI":"10.1016\/j.jhepr.2025.101486","article-title":"Odevixibat Treatment Reverses Severe Phenotype of PFIC in a Young Adult: A Real-Life Experience beyond the Genetic Diagnosis","volume":"7","author":"Mandato","year":"2025","journal-title":"JHEP Rep."},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"632","DOI":"10.1016\/S2468-1253(24)00074-8","article-title":"Efficacy and Safety of Odevixibat in Patients with Alagille Syndrome (ASSERT): A Phase 3, Double-Blind, Randomised, Placebo-Controlled Trial","volume":"9","author":"Ovchinsky","year":"2024","journal-title":"Lancet Gastroenterol. Hepatol."},{"key":"ref_104","doi-asserted-by":"crossref","first-page":"101309","DOI":"10.1016\/j.jhepr.2024.101309","article-title":"Real-World Experience with Odevixibat in Children with Progressive Familial Intrahepatic Cholestasis","volume":"7","author":"Sciveres","year":"2025","journal-title":"JHEP Rep."},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"1581","DOI":"10.1016\/S0140-6736(21)01256-3","article-title":"Efficacy and Safety of Maralixibat Treatment in Patients with Alagille Syndrome and Cholestatic Pruritus (ICONIC): A Randomised Phase 2 Study","volume":"398","author":"Gonzales","year":"2021","journal-title":"Lancet"},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1111\/apt.70666","article-title":"Review Article: Ileal Bile Acid Transport (IBAT) Inhibitors as an Emerging Treatment for Cholestatic Liver Disease","volume":"64","author":"Peverelle","year":"2026","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_107","doi-asserted-by":"crossref","first-page":"e70523","DOI":"10.1111\/liv.70523","article-title":"Efficacy, Safety and Tolerability of Volixibat, an IBAT Inhibitor, in Patients With Intrahepatic Cholestasis of Pregnancy","volume":"46","author":"Ovadia","year":"2026","journal-title":"Liver Int."},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"e949019","DOI":"10.12659\/AJCR.949019","article-title":"Exploring Maralixibat for Treatment-Resistant Pruritus in Intrahepatic Cholestasis of Pregnancy and Primary Biliary Cholangitis: A Case Report","volume":"26","author":"Bersuch","year":"2025","journal-title":"Am. J. Case Rep."},{"key":"ref_109","doi-asserted-by":"crossref","first-page":"e133","DOI":"10.1016\/j.jhep.2025.05.018","article-title":"Use of Maralixibat in Severe and Recurrent Intrahepatic Cholestasis of Pregnancy with Concurrent Benign Recurrent Intrahepatic Cholestasis","volume":"83","author":"Rodriguez","year":"2025","journal-title":"J. Hepatol."},{"key":"ref_110","doi-asserted-by":"crossref","first-page":"679","DOI":"10.1038\/s42003-026-09869-4","article-title":"Lactobacillus Paragasseri LPG-9 Reduces Placental Inflammation in Intrahepatic Cholestasis of Pregnancy by Regulating TGR5 in Mice","volume":"9","author":"Huang","year":"2026","journal-title":"Commun. Biol."},{"key":"ref_111","doi-asserted-by":"crossref","first-page":"e72173","DOI":"10.1002\/fsn3.72173","article-title":"Postbiotics in Food Systems: Components, Production Methods, Food Applications, Functional Properties, and Technological Challenges","volume":"14","author":"Taspinar","year":"2026","journal-title":"Food Sci. Nutr."},{"key":"ref_112","doi-asserted-by":"crossref","first-page":"649","DOI":"10.1038\/s41575-021-00440-6","article-title":"The International Scientific Association of Probiotics and Prebiotics (ISAPP) Consensus Statement on the Definition and Scope of Postbiotics","volume":"18","author":"Salminen","year":"2021","journal-title":"Nat. Rev. Gastroenterol. Hepatol."},{"key":"ref_113","doi-asserted-by":"crossref","unstructured":"Cheong, K.-L., Pan, T., Wang, M., Wang, D., and Zhong, S. (2026). Impact of Prebiotics, Probiotics, and Postbiotics on Maternal and Fetal Health: Mechanisms, Efficacy, and Safety across Pregnancy. Pediatr. Res.","DOI":"10.1038\/s41390-026-04983-9"},{"key":"ref_114","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1046\/j.1471-0528.2003.00029.x","article-title":"A Randomised Controlled Trial of Ursodeoxycholic Acid and S-adenosyl-l-methionine in the Treatment of Gestational Cholestasis","volume":"111","author":"Roncaglia","year":"2004","journal-title":"BJOG Int. J. Obstet. Gynaecol."},{"key":"ref_115","first-page":"1084","article-title":"S-Adenosyl-L-Methionine in the Treatment of Patients with Intrahepatic Cholestasis of Pregnancy: A Randomized, Double-Blind, Placebo-Controlled Study with Negative Results","volume":"13","author":"Ribalta","year":"1991","journal-title":"Hepatology"},{"key":"ref_116","doi-asserted-by":"crossref","unstructured":"Wang, M., Chen, L., Li, J., You, Y., Qian, Z., Liu, J., Jiang, Y., Zhou, T., Gu, Y., and Zhang, Y. (2024). An Omics Review and Perspective of Researches on Intrahepatic Cholestasis of Pregnancy. Front. Endocrinol., 14.","DOI":"10.3389\/fendo.2023.1267195"},{"key":"ref_117","doi-asserted-by":"crossref","first-page":"509","DOI":"10.2217\/bmm-2023-0190","article-title":"A Comprehensive Review of Novel Biomarkers in the Diagnosis of Intrahepatic Cholestasis of Pregnancy","volume":"17","author":"Liu","year":"2023","journal-title":"Biomark. Med."},{"key":"ref_118","first-page":"159692","article-title":"Integrated Proteomic and Metabolomic Analysis Reveals Lipid Metabolic Dysregulation and Ferroptosis as Potential Drivers of Placental Dysfunction in Intrahepatic Cholestasis of Pregnancy","volume":"1871","author":"Dong","year":"2026","journal-title":"Biochim. Biophys. Acta (BBA)\u2014Mol. Cell Biol. Lipids"},{"key":"ref_119","doi-asserted-by":"crossref","first-page":"2361278","DOI":"10.1080\/14767058.2024.2361278","article-title":"Single-Cell RNA Sequencing Reveals Heterogeneity and Differential Expression of the Maternal\u2013Fetal Interface during ICP and Normal Pregnancy","volume":"37","author":"Liu","year":"2024","journal-title":"J. Matern.-Fetal Neonatal Med."},{"key":"ref_120","doi-asserted-by":"crossref","first-page":"146594","DOI":"10.1016\/j.gene.2022.146594","article-title":"Comprehensive Analysis of Placental Gene-Expression Profiles and Identification of EGFR-Mediated Autophagy and Ferroptosis Suppression in Intrahepatic Cholestasis of Pregnancy","volume":"834","author":"Fang","year":"2022","journal-title":"Gene"},{"key":"ref_121","doi-asserted-by":"crossref","first-page":"2614842","DOI":"10.1080\/14767058.2026.2614842","article-title":"Innovative Nomogram Integrating Bile Acid Metabolomics for Early Diagnosis of Intrahepatic Cholestasis of Pregnancy","volume":"39","author":"Han","year":"2026","journal-title":"J. Matern.-Fetal Neonatal Med."},{"key":"ref_122","doi-asserted-by":"crossref","first-page":"2413854","DOI":"10.1080\/14767058.2024.2413854","article-title":"Predictive Efficacy of Machine-Learning Algorithms on Intrahepatic Cholestasis of Pregnancy Based on Clinical and Laboratory Indicators","volume":"38","author":"He","year":"2025","journal-title":"J. Matern.-Fetal Neonatal Med."},{"key":"ref_123","doi-asserted-by":"crossref","first-page":"570357","DOI":"10.2147\/IJGM.S570357","article-title":"Predicting Intrahepatic Cholestasis of Pregnancy: A Retrospective Cohort Study of a Comprehensive Clinical Prediction Model","volume":"19","author":"Liang","year":"2026","journal-title":"Int. J. Gen. Med."},{"key":"ref_124","doi-asserted-by":"crossref","unstructured":"Ren, Y., Shan, X., Ding, G., Ai, L., Zhu, W., Ding, Y., Yu, F., Chen, Y., and Wu, B. (2025). Risk Factors and Machine Learning Prediction Models for Intrahepatic Cholestasis of Pregnancy. BMC Pregnancy Childbirth, 25.","DOI":"10.1186\/s12884-025-07180-4"},{"key":"ref_125","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1007\/s11883-022-01078-8","article-title":"From \u2018Omics to Multi-Omics Technologies: The Discovery of Novel Causal Mediators","volume":"25","author":"Sood","year":"2023","journal-title":"Curr. Atheroscler. 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