ABSTRACT
RISK FACTORS/ASSOCIATIONS There is a higher incidence of ICP in women with multiple pregnancies, in women who have conceived after in vitro fer tilization (2.7% compared with 2%), and in women older than 35 years of age. Multiparity, family clustering, ICP in previous pregnancy, and a history of oral contraceptive use are also associated with an increased incidence of ICP. Recurrence of ICP has been reported to occur between 40% and 60% with varying intensity in subsequent pregnancies in a random manner. Several environmental factors have been reported to play a role in the etiology of ICP in genetically susceptible individuals: high maternal serum copper and low maternal serum selenium and zinc. Interestingly, ICP is more com mon in some countries during the winter, when natural sele nium levels are lower. Deficiency of vitamin D has been also reported in women with ICP [2,11].
