Highlight
- Peak bile acid levels and maternal BMI are independent predictors for pruritus severity deterioration in intrahepatic cholestasis of pregnancy (ICP).
- Over half (53%) of women with ICP experience worsening pruritus as pregnancy advances, particularly those with severe ICP (peak bile acids ≥ 100 μmol/L).
- Baseline liver function tests do not reliably predict pruritus progression; dynamic changes in bile acid levels during gestation are more informative.
- Findings stress the importance of individualized monitoring and management strategies for women with ICP, especially those with higher BMI or severe biochemical derangements.
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