Many congratulations to Professor Catherine Williamson, Professor of Women’s Health, Imperial College London, United Kingdom, the 2026 winner of the biannual Adolf Windaus Award which recognises outstanding achievement in the field of bile acids.

Professor Williamson received her award at the Falk Foundation Symposium XXVIII International Bile Acid Meeting in Vienna, honoured for her groundbreaking research and collaborations within the field of intrahepatic cholestasis in pregnancy (ICP), and her role in transforming the management and outcomes of these patients and their babies. 

The award was instigated by the Falk Foundation in 1980, in memory of Dr Windaus, a German born chemist who won the Nobel Prize in 1928, for his research into sterols, and in particular cholesterols. Being added to this distinguished roster came as complete surprise to Professor Williamson.

‘This is one of my favourite meetings,’ says Professor Williamson ‘The science is outstanding and I always leave invigorated and updated. I have listened to prize winners giving their lectures so to be invited to join the ranks of these amazing professionals is a huge compliment. It left me very humbled.’

Professor Williamson holds an outstanding body of work in a career that spans nearly thirty years.  Alongside her clinical role, she is a Fellow of the Academy of Medical Sciences and an Honorary Fellow of the Royal College of Obstetrics and Gynaecology. She is the Maternal Medicine Representative on the RCOG Genomics Committee and one of the founders and now Lead of the Women’s Health Research Centre at Imperial College London and the Director of the Tommy’s National Centre for Preterm Birth Research. She has been the Chair of the European and FIGO guideline committees for the management of liver disorders in pregnancy.

Professor Williamson first became interested in ICP whilst completing her training in general medicine.

‘In most pregnancy clinics I attended, there would be one or two women referred with abnormal liver tests and raised bile acids,’ she remembers. ‘Not only did we not know what was causing this issue, but the disease was considered benign for both mother and baby. A disease of pregnancy that would just disappear after the baby was born.

‘Yet I was speaking to women, who were being driving to distraction by itching, with some reporting feeling suicidal. Women having severely preterm babies and even stillbirths. It didn’t look very benign to me’.

Her Eureka moment came when a woman attended the clinic with her mother, who had suffered the same symptoms during her pregnancy. 

‘I realised that there could be a genetic component. I applied for and received a fellowship grant from the Wellcome Trust and that's how my research began.’

From that start, Professor Williamson’s research group has gone on to identify and explain many of the causes, components and consequences of ICP. An early achievement was to determine that genetic factors could indeed contribute to the development of ICP, later work identified the role of pregnancy hormones in raising the levels of bile acids in predisposed women. In 2019, the group published a paper which demonstrated thresholds for high bile acid levels above which they play a role in ICP-associated stillbirth and preterm labour and that treatment with ursodeoxycholic acid reduces the preterm birth rate. These findings are now quoted in national and international guidelines.  

‘We now know that for the 10% of women with ICP who have serum bile acid concentrations above 100 µmol/L, the risk of stillbirth rises markedly at 35-36 weeks of pregnancy, so the advice is to induce birth at this stage,’ she explains. ‘However, that means that for the other 90% it is not necessary to have an induced preterm delivery.
‘It was a wonderful feeling to be part of this huge change in ICP management.  I remember thinking that if I fell under a bus when cycling to work the next day, I would know I have achieved something worthwhile in my life.’

Luckily, for all the 8,000 or so women who are diagnosed with ICP in the UK each year, this didn’t happen.  However, there is still the need for more work to be done in this field. The prize money from the award will fund a researcher to work on developing a predictive algorithm to try to determine which women with raised bile acid concentrations will deliver early and those who won’t.’ 
An additional focus is on the long-term health of the baby. ‘We often say that pregnancy is a window on the future health of the mother,’ notes Professor Williamson. ‘We are now learning that it is a window for her child too. It is incredibly important that we understand how to protect the child from the consequences of maternal disease. There is still a lot of work to do.’