CHAMGAP
VERIFIEDPassed the Codex final verification and publication gate. Evidence-verification cutoff: 2026-08-26. AI was used for research and drafting; the existence of all 1 cited sources was verified at the original page, followed by blind grading, adversarial audit, and build validation. Methodology v0.8.
Verdict No. 2890 · Search date 2026-08-26 · Methodology v0.8

Ursodeoxycholic acid,
does it really help with Reduction of adverse perinatal outcomes in intrahepatic cholestasis of pregnancy?

30-Second Summary
D
Evidence Grade D · 34 · Safety acceptable
Adverse infant outcomes were not significantly reduced, but important benefit was not excluded
No treatment-related serious adverse event was identified, but pregnancy treatment requires obstetric oversight.
What the
research shows
Grade D. Perinatal death, preterm birth before 37 weeks, or neonatal-unit admission for at least 4 hours occurred in 74/322 (23%) versus 85/318 (27%), adjusted RR 0.85 (95% CI 0.62-1.15), absolute difference -4 points. The result was null, but the interval retains a potentially important 38% relative reduction.
What the
ads claim
Use of UDCA in other cholestatic diseases does not prove protection of infants in intrahepatic cholestasis of pregnancy.
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Useful facts when choosing a product

  • 605 women were randomized at 33 UK maternity units.
  • Serious adverse events were 2 versus 6; none was considered treatment-related.
Gap Measurement · Verdict 2890 · D 34
What advertising claims
What independent, higher-quality research supports
△ GAP
01

What the research actually shows

Axis 6 B0 evidence ① Allocation concealment: "Randomisation was done via a secure web-based randomisation facility." ② Blinding: "women, clinicians, outcome assessors, and analysts were masked to allocation." ③ Analysis set and missingness: "All analyses were done according to the intention-to-treat principle"; one of 605 withdrew data consent. ④ Prespecified primary endpoint: registered death, preterm birth, or neonatal admission composite - consistent with ISRCTN91918806

Four gates: ① Defect: none. ② Listed item: none. ③ Evidence: secure central web allocation, full masking, ITT, registered endpoint. ④ Avoidability: apart from 1/605 (0.17%) consent withdrawal, no confirmed avoidable defect. Funded by the NIHR Efficacy and Mechanism Evaluation Programme.

02

Why this is classified as D (34)

A large public hard-outcome RCT was null, but its CI did not exclude important benefit, giving D with 34 points.

Counterpoint. A small secondary itch improvement cannot substitute for infant outcomes.

Rejudgment record. Source verified — Large public hard-outcome RCT with a confidence interval retaining important benefit

Scoring profile behind this grade
EndpointHHard endpoint - actual events such as death
ReplicationR1Single confirmatory trial
IndependenceI2Decisive evidence is publicly or non-profit funded
Effect sizeE0Null
PrecisionC0The confidence interval leaves room for benefit

The scoring table and the verdict agree (D).

Sub-claim grades by effect

This ingredient is marketed for several effects. A single overall grade blends strong and weak claims together, so each effect is graded separately here. The overall grade reflects the strongest disconfirming or core claim.

Effect (sub-claim)GradeBasis
Reduced adverse perinatal compositeDRR 0.85 (0.62-1.15) was null but did not exclude important benefit.
Maternal itch improvementCSecondary itch improved slightly by -5.7 mm.

Cross-check — AI research and Codex final gate

AI was used for research and drafting. Blind grading, adversarial audit, and the methodology boundary rules were then reapplied before Codex performed the final evidence, grade, copy, and build checks. If a grade cannot be narrowed, both evidence positions and their reasons are published.
03

Evidence Table

StudyDesignSampleFundingEndpointResultWeight
Study 133-center double-blind placebo-controlled randomized trial604Public NIHR Efficacy and Mechanism Evaluation Programme fundingComposite of perinatal death, birth before 37 weeks, or neonatal-unit admission for at least 4 hours74/322 (23%) versus 85/318 (27%), adjusted RR 0.85 (95% CI 0.62-1.15), absolute difference -4 pointsLarge publicly funded null hard-outcome trial
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Receipt — 1 References

All 1 cited sources were verified for existence at the original page (as of 2026-08-26).

Chappell LC, Bell JL, Smith A, et al. Ursodeoxycholic acid versus placebo in women with intrahepatic cholestasis of pregnancy (PITCHES): a randomised controlled trial. Lancet. 2019;394:849-860. PMID: 31378395.
checked
Research and draft: AI used · Cross-check: blind grading and adversarial audit
Final verification and publication gate: Codex · Verification cutoff: 2026-08-26 · Corrections: none

Cite this verdict

No Benefit of Ursodeoxycholic Acid for Adverse Perinatal Outcomes in Intrahepatic Cholestasis of Pregnancy Evidence Grade D card
[Chamgap] No Benefit of Ursodeoxycholic Acid for Adverse Perinatal Outcomes in Intrahepatic Cholestasis of Pregnancy — Evidence Grade D·34. 1 cited sources checked. Source: https://chamgap.com/en/verdicts/womens/ursodeoxycholic-acid-adverse-perinatal-outcomes-intrahepatic-cholestasis-pregnancy/ · CC BY 4.0

CC BY 4.0 — free to use with attribution; do not distort grades, numbers, or verdict meaning.

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What this document does and does not do

Chamgap is an information source. It reports what research has and has not confirmed; it does not tell readers what to take or buy. That decision belongs to readers and, when needed, medical or legal professionals. This verdict reflects literature available up to the search date and may change as new research appears. Nothing here is medical advice.