Bile acid concentration reference ranges in a pregnant Latina population

Am J Perinatol. 2013 May;30(5):389-93. doi: 10.1055/s-0032-1326982. Epub 2012 Nov 16.


Objective: The total bile acid (TBA) concentration criterion for diagnosing intrahepatic cholestasis of pregnancy varies in the published literature. The purpose of this study was to establish pregnancy-specific reference ranges for the TBA concentration among Latina women.

Study design: Self-identified Latina women (n = 211) over 18 years of age with a singleton pregnancy were recruited and had random serum samples drawn during the second and third trimesters. The total and fractionated bile acid concentrations were analyzed by liquid chromatography-tandem mass spectrometry (LC-MS/MS), and reference ranges were calculated. Laboratory-provided general reference ranges from a general population of adult men and nonpregnant women were used for comparison.

Results: The TBA reference range for our Latina pregnant population (<8.5 µmol/L) was markedly lower than the laboratory-provided reference range (4.5 to 19.2 µmol/L).

Conclusion: These data suggest that the upper TBA concentration reference range in our Latina pregnant population is 8.5 µmol/L, based on LC-MS/MS measurements.

MeSH terms

  • Adult
  • Bile Acids and Salts / blood*
  • Case-Control Studies
  • Chenodeoxycholic Acid / blood
  • Cholestasis, Intrahepatic / blood
  • Cholestasis, Intrahepatic / diagnosis
  • Cholic Acid / blood
  • Chromatography, Liquid
  • Deoxycholic Acid / blood
  • Female
  • Hispanic or Latino
  • Humans
  • Male
  • Pregnancy / blood*
  • Pregnancy Complications / blood
  • Pregnancy Complications / diagnosis
  • Pregnancy Trimester, Second / blood
  • Pregnancy Trimester, Third / blood
  • Reference Values
  • Tandem Mass Spectrometry
  • Young Adult


  • Bile Acids and Salts
  • Deoxycholic Acid
  • Chenodeoxycholic Acid
  • Cholic Acid