Ursodeoxycholic acid in pregnancy?复制标题

熊去氧胆酸在妊娠？

There are no guideline recommendations for UDCA treatment during lactation since data on UDCA  treatment and bile acid levels in breast milk are scarce, but toxicity of UDCA when administered at  recommended doses in cholestatic neonates and infants is not known. Only a few case reports have addressed the issue of UDCA in breastmilk. One German case report analyzed patient’s breast milk by high pressure liquid chromatography while she was treated with UDCA at a dose of 750mg/day. No UDCA was detected, in contrast to the more hydrophobic cholic acid, deoxycholic acid and lithocholic acid 67. A more recent case report analyzed bile acids in breast milk at a UDCA dosage up to 1500mg/day and found no effect of UDCA at increasing doses on breast milk bile acid content; development of the child was normal 68. The most relevant study on UDCA therapy and breast milk was performed in ICP patients 69. Bile acid excretion in colostrum from 16 lactating ICP patients was compared to that in colostrum of five healthy lactating mothers. In ICP patients treated with UDCA compared to non-treated women excretion of total bile acid in colostrum was substantially decreased. Accumulation of UDCA in colostrum was very limited and the concentration ingested by the nursing infant irrelevant. The breastfeeding infant would be exposed to less than 0.01% of the UDCA administered to the mother with an estimated total daily dose of approximately 12 µg. No side effects were encountered in breastfeeding infants whose mothers continued UDCA treatment during lactation 45.

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