Last updated May 16, 2026
Key finding
A randomized trial in 113 women with gestational diabetes found that ursodeoxycholic acid was associated with small improvements in left atrial function in the third trimester and postpartum, suggesting possible cardiovascular benefits beyond glycemic control.
This randomized trial tested whether ursodeoxycholic acid (UDCA), a bile acid medication, could improve heart function in pregnant women with gestational diabetes. Women who received UDCA showed small improvements in left atrial function during late pregnancy and 3 months after giving birth compared to placebo, though overall heart function changes were modest.
Quick read
The essential study design details in one scan.
EvidenceScore™
Moderate
Study type
Randomized Controlled Trials (RCTs)
Follow-up
Medium-Term (3–12 mo)
Risk of bias
Some Concerns
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Plain-language summary
A plain-language read of the study’s main message and where it applies.
Study focus
A randomized trial in 113 women with gestational diabetes found that ursodeoxycholic acid was associated with small improvements in left atrial function in the third trimester and postpartum, suggesting possible cardiovascular benefits beyond glycemic control.
Published in
Publication details and source links for this paper.
Calabuig AMC, Blanco-Carnero JE, Chatzakis C, et al. The Impact of Ursodeoxycholic Acid on Maternal Cardiac Function in Women with Gestational Diabetes Mellitus: A Randomized Controlled Study (GUARDS Trial). J Clin Med. 2026;15(2):786. doi:10.3390/jcm15020786
UDCA ↑ Left atrial contractile strain at 36 weeks (LASct_AC, p=0.016) compared to placebo ↓
UDCA ↑ Left atrial reservoir function postpartum (LASr_ED p=0.041, LASr_AC p=0.036) ↓
No significant differences in left ventricular ejection fraction or right ventricular function ↓
Evidence network
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This study contributes evidence to Ursodeoxycholic acid and Left atrial contractile strain (LASct_AC), Left atrial reservoir strain (LASr_ED), Left ventricular ejection fraction (LVEF).
This study contributes evidence to
Primary intervention
Ursodeoxycholic acid
Primary outcomes
Primary intervention
Intervention and outcome relationships this study adds to the evidence network.
Editorial context
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Evidence network role
This section describes how the study fits into the current evidence network. It does not determine whether an intervention works on its own.
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Related topics
3
Evidence pairs
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Primary evidence
Evidence relationship
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Intervention
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Outcome
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Core evidence
The primary outcomes reported in this study.
Ursodeoxycholic acid → Left atrial contractile strain (LASct_AC)
Ursodeoxycholic acid → Left atrial contractile strain (LASct_AC)
Ursodeoxycholic acid → Left atrial reservoir strain (LASr_ED)
Ursodeoxycholic acid → Left atrial reservoir strain (LASr_ED)
Ursodeoxycholic acid → Left ventricular ejection fraction (LVEF)
Ursodeoxycholic acid → Left ventricular ejection fraction (LVEF)
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This study applies to women diagnosed with gestational diabetes mellitus who are being treated with standard glycemic management and may have interest in additional cardiovascular protective therapies during and after pregnancy.
This is a cardiac sub-study from a single-center trial that was not powered for echocardiographic outcomes. The per-protocol analysis (excluding UDCA-treated women with low drug levels) may introduce bias. The clinical significance of small changes in left atrial strain parameters is uncertain without long-term follow-up data.
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Relationships organized using the Dediabetes Evidence Intelligence™ framework.
This study contributes to evidence on Omega-3 Fatty Acid Supplements and Left atrial contractile strain (LASct_AC), Omega-3 Fatty Acid Supplements and Left atrial reservoir strain (LASr_ED).
This study contributes to the evidence on the following intervention-outcome relationships.
Curated evidence collections and hubs this study is part of.
All studies measuring Left atrial contractile strain (LASct_AC)
Measures Left atrial contractile strain (LASct_AC) as a key outcome.
All studies measuring Left atrial reservoir strain (LASr_ED)
Measures Left atrial reservoir strain (LASr_ED) as a key outcome.
All studies on Omega-3 Fatty Acid Supplements
Contributes to Omega-3 Fatty Acid Supplements evidence base.
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1 results
1 results
1 results
1 results
1 results
Generated from the study's connected evidence using Evidence Intelligence™.
Omega-3 Fatty Acid Supplements may improve Left Ventricular Structure.
ConsistencyScore™: Consistency cannot yet be determined from the available evidence.
Ranked evidence signals
Left ventricular ejection fraction (LVEF)
EvidenceScore™ Emerging | EvidenceScore™ 59.0 | weak positive | ConsistencyScore™ Unclear | 1 study
Why this answer: This answer is based on a single supporting study.
Limitations
Ursodeoxycholic acid may improve Left atrial contractile strain (LASct_AC).
ConsistencyScore™: Consistency cannot yet be determined from the available evidence.
Ranked evidence signals
Left atrial contractile strain (LASct_AC)
EvidenceScore™ Emerging | EvidenceScore™ 59.0 | weak positive | ConsistencyScore™ Unclear | 1 study
Why this answer: This answer is based on a single supporting study.
Limitations
Ursodeoxycholic acid may improve Left atrial reservoir strain (LASr_ED).
ConsistencyScore™: Consistency cannot yet be determined from the available evidence.
Ranked evidence signals
Left atrial reservoir strain (LASr_ED)
EvidenceScore™ Emerging | EvidenceScore™ 59.0 | weak positive | ConsistencyScore™ Unclear | 1 study
Why this answer: This answer is based on a single supporting study.
Limitations
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