Objective: To analyze the risk factors of intrahepatic cholestasis of pregnancy and its influence on pregnancy outcome. Methods: A total of 91 pregnant women with intrahepatic cholestasis of pregnancy admitted to Wuxi Maternal and Child Health Hospital from June 2019 to June 2021 were selected as an observation group, and 120 pregnant women who came to our hospital for normal obstetric examination during the same period were selected as a control group. The clinical data of the 2 groups of pregnant women were retrospectively analyzed, and the risk factors for intrahepatic cholestasis of pregnancy were analyzed by univariate and multivariate logistic regression analysis, and the favorable pregnancy outcomes were compared. Results: The proportion of family history of intrahepatic cholestasis of pregnancy, the proportion of hepatitis B virus infection, the proportion of twins and above, the proportion of positive urine protein, the proportion of hypertension in pregnancy, the proportion of diabetes in pregnancy, the proportion of high estrogen, the proportion of autoimmune diseases, and the proportion of low selenium intake and low zinc intake in the observation group were higher than those in the control group, and except for albumin, the indexes of liver and kidney function were higher than those in the control group, and the differences were statistically significant (all P<0.05). Multivariate logistic regression analysis showed that family history of intrahepatic cholestasis of pregnancy, hepatitis B virus infection, twins and above, positive urine protein, gestational hypertension, high estrogen, autoimmune disease, and low selenium intake were the risk factors for intrahepatic cholestasis of pregnancy (all P<0.05). The incidences of premature birth, premature rupture of membranes, and postpartum hemorrhage in the observation group were higher than those in the control group (all P<0.05). The incidences of intrauterine distress, amniotic fluid pollution, and low birth weight infants in the observation group were higher than those in the control group, and the 5 min Apgar score of the neonates was lower than that in the control group (all P<0.05). Conclusion: The risk factors of intrahepatic cholestasis of pregnancy are family history of intrahepatic cholestasis of pregnancy, hepatitis B virus infection, twins and above, positive urine protein, gestational hypertension, high estrogen, autoimmune diseases, and low intake of selenium, which will increase maternal perinatal complications and affect perinatal outcomes.