There were few differences between the ICP patients and control women except for a higher frequency of later hepatobiliary disease, breast cancer and hypothyreosis. Women with a history of ICP should be screened for hypothyreosis more readily than those without. The higher frequency of breast cancer warrants further research.

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Introduction Intrahepatic cholestasis of pregnancy (ICP) is a reversible liver disorder occurring during pregnancy. It has a typical genetic background with known genetic mutations and can be considered an expression of this genetic predisposition. The objective of this study was to determine whether ICP is associated with specific long‐term comorbidity. Material and methods The study population comprised 571 women with ICP in at least one pregnancy who were compared with 1333 pregnant women without ICP during 1969‐1988 at Tampere University Hospital, Finland. The cohort's follow‐up time was 44 years. All ICD‐10 classification discharge diagnoses were examined for the women in the ICP group from 1998 to 2013 and ICD‐10 diagnoses from outpatient care from 1969 to 2013. Results At least one disease of the digestive system had been diagnosed in 50.4% (288/571) of the ICP mothers compared with 34.4% (459/1333) of the reference group (P < 0.001). In a more detailed analysis, women with a history of ICP had an increased risk for cholelithiasis and/or cholecystitis (odds ratio [OR] 2.88, 95% confidence interval [CI] 2.17 to 3.84), diseases of the pancreas (OR 2.26, 95% CI 1.20 to 4.27) and hypothyroidism (OR 2.38, 95% CI 1.27 to 4.46) compared with the reference group. Arterial diseases were less common in the ICP mothers than in the reference group (OR 0.38, 95% CI .15 to .99). Regarding other diseases, there were no statistically significant differences between the ICP mothers and reference group. Conclusions Half of the women with a history of ICP were diagnosed with at least one disease of the digestive system compared with a third in the reference group. The risk of cholelithiasis, cholecystitis, diseases of the pancreas and hypothyroidism was increased compared with the reference group. These are important facts when counseling women after a pregnancy with ICP. Also, this is of importance for the general practitioners and other physicians who take care of these women.

Intrahepatic cholestasis of pregnancy has been shown to have a genetic predisposition. We studied whether Finnish women who had suffered from the disorder reported their first-degree relatives to have had liver dysfunction during their pregnancies. Questionnaires were sent in autumn 2010 to a total of 544 former intrahepatic cholestasis of pregnancy patients and 1235 controls, all having delivered during 1969-1988. The response rate was 66.2%. The incidence of intrahepatic cholestasis is 0.5-1.5% of pregnancies in Finland. In our survey, altogether 12.8% of mothers (odds ratio 9.2), 15.9% of sisters (odds ratio 5.3) and 10.3% of daughters (odds ratio 4.8) of women who had suffered from intrahepatic cholestasis of pregnancy had had liver dysfunction during pregnancy. Our findings strengthen the earlier knowledge of the genetic component in intrahepatic cholestasis of pregnancy. We suggest that all pregnant women are asked about their family history regarding liver dysfunction during pregnancy.

Objective: In a previous questionnaire study, more breast cancers were reported by women with intrahepatic cholestasis of pregnancy (ICP) than by the controls. The aim of this study was to establish whether ICP is associated with cancer in the Finnish Cancer Registry data, the study population being the same cohort as in the questionnaire study. Methods:The study population comprised 571 women with ICP in at least one pregnancy and 1,333 controls from Tampere University Hospital in Finland during [1969][1970][1971][1972][1973][1974][1975][1976][1977][1978][1979][1980][1981][1982][1983][1984][1985][1986][1987][1988]. The cancer data were obtained from the Finnish Cancer Registry. The cancers were classified by ICD-O-3 and diagnosed during the period 1953−2013. Results:In the ICP group, the odds ratio of cancers (OR 1.26, 95% CI 0.96-1.64), and breast cancer in particular (OR 1.36, 95% CI 0.91-2.03), was slightly higher than in the control group. Seven percent of the ICP group and 5.3% of the control group had breast cancer. Conclusion:Based on this study there is not a significant association between ICP and cancer. Earlier observation in the questionnaire study regarding association between ICP and breast cancer cannot be confirmed by this registry based study.