Intrahepatic Cholestasis of Pregnancy Recurrence in a Subsequent Pregnancy

Reported recurrence rates of intrahepatic cholestasis of pregnancy (ICP) range from 40% to 90% based on prior literature, but data remain limited. In a retrospective cohort, we aimed to evaluate the rate of ICP recurrence and risk factors associated with recurrence. Among 104 patients with ICP in an index pregnancy, 46 experienced recurrence (44%) of ICP in subsequent pregnancy. A peak total bile acid (TBA) level greater than 40 micromoles/L in the index pregnancy was significantly associated with ICP recurrence; shorter interpregnancy intervals were associated with lower risk. These findings contribute to the literature on the risk of ICP recurrence in a modern, racially diverse cohort and highlight elevated TBA level as a predictor of recurrence.