Maternal BMI Shows No Clear Link to Pregnancy Cholestasis, Review Finds

The authors carried out the review in accordance with PRISMA-ScR guidelines, the standard reporting framework for scoping reviews. They searched PubMed and EMBASE for studies published between 2000 and 2025 that examined BMI and/or gestational weight gain in relation to ICP. Animal studies, case reports, and studies lacking relevant exposure or outcome data were excluded. Twenty studies met the criteria and were included in the synthesis.

On BMI, the findings across the included studies were inconsistent, with most studies showing no clear association with the development of ICP. This stands in contrast to gestational weight gain, where lower weight gain was more consistently associated with ICP across the reviewed literature. However, the review found that evidence regarding associations between BMI, gestational weight gain and the severity of ICP was limited, meaning that questions about whether these weight-related factors influence how severe the condition becomes remain largely unanswered.

The authors caution that several factors limit how the gestational weight gain finding can be interpreted. The available studies were largely retrospective in design, heterogeneous in their methods, and varied in when weight measurements were taken during pregnancy. A further concern is possible reverse causation: rather than lower weight gain contributing to ICP, it is conceivable that the condition itself, or its symptoms and clinical management, could affect how much weight a woman gains over the course of pregnancy. Disentangling such directions of effect requires study designs that the current literature largely does not provide.

Because this is a scoping review, its purpose was to map the available literature and identify knowledge gaps rather than to pool data and produce a single summary estimate of effect. The authors conclude that prospective or register-based studies using standardized measures and biomarkers are needed to address the remaining gaps regarding the association between maternal weight-related factors and ICP. Until such studies are available, the review suggests that maternal BMI should not be regarded as an established risk factor for the condition, while the observed link between lower gestational weight gain and ICP warrants further, more rigorous investigation.

Subject of Research: The association between maternal body mass index, gestational weight gain and intrahepatic cholestasis of pregnancy

Article Title: The impact of maternal body mass index and weight changes in intrahepatic cholestasis of pregnancy: a scoping review

Article References: Bech, T., Maigaard, S., & Fuglsang, J. (2026). The impact of maternal body mass index and weight changes in intrahepatic cholestasis of pregnancy: a scoping review. Archives of Gynecology and Obstetrics. https://doi.org/10.1007/s00404-026-08573-2

Image Credits: AI Generated

DOI: 10.1007/s00404-026-08573-2

Keywords: intrahepatic cholestasis of pregnancy, body mass index, gestational weight gain, scoping review, pregnancy, liver disease, PRISMA-ScR, PubMed, EMBASE, maternal health, impact, maternal