Temporal Analysis of Gestation at Birth in Pregnancies Complicated by Intrahepatic Cholestasis of Pregnancy

Intrahepatic cholestasis of pregnancy (ICP) is associated with maternal morbidity and adverse perinatal outcomes and has historically been managed with planned early birth. This retrospective study examined temporal trends in gestational age at birth among 943 ICP pregnancies at an Australian tertiary hospital between 2014 and 2024, spanning three local policy updates. There was a progressive shift in gestational age distribution from 37 weeks towards later gestations over time. Although the majority of cases were mild or severe disease, 18.1% of births were preterm, of which 84.2% were iatrogenic, suggesting an ongoing opportunity to improve adherence to guideline-recommended timing of birth.