Objective To systematically evaluate the risk factors of intrahepatic cholestasis of pregnancy，in order to provide evidence-based support for clinical staff to identify and make risk strategies in advance.Methods By searching PubMed，Embase，The Cochrane Library，Web of Science，CNKI，VIP，WanFang Data and CBM databases for relevant studies on the risk factors of intrahepatic cholestasis of pregnancy，and manually searching other literatures.The retrieval period is from the establishment of the database to No⁃ vember 2022.The types of studies mainly included case control studies.Results Twenty-one literatures were included，with a total of 61650 patients.The results of meta-analysis showed that: Advanced age（OR = 1.42，95%CI 1.17 ~ 1.72），family OR medical history of ICP（OR = 6.17，95%CI 4.66 ~ 8.16），hepatitis B virus infection OR combined hepatobiliary disease（OR = 4.12，95%CI 3.61 ~ 4.69），hypertension during pregnancy（OR = 4.01，95%CI 3.30 ~ 4.88），gestational diabetes mellitus（OR = 4.59，95%CI 3.30 ~ 6.39），auto⁃ immune disease（OR = 4.91，95%CI 3.78 ~ 6.38），urine protein positive（OR = 6.43，95%CI 4.22 ~ 9.81），high estrogen（OR = 26.90，95%CI 19.53 ~ 37.06），progesterone treatment（OR = 3.04，95%CI 2.51 ~ 3.68），multiple pregnancy（OR = 15.64，95%CI 7.95 ~ 30.75），low selenium intake（OR = 8.52，95%CI 6.37 ~ 11.41）、low zinc intake（OR = 2.90，95%CI 1.97 ~ 4.26）and multiparous （OR = 0.12，95%CI 0.08 ~ 0.16）were the main risk factors for intrahepatic cholestasis during pregnancy，and the difference was statis⁃ tically significant（P < 0.05）.Conclusions Advanced age，family history or history of ICP，hepatitis B virus infection or combined hepatobiliary disease，gestational hypertension，gestational diabetes，autoimmune disease，positive urinary protein，high estrogen，proges⁃ terone fetal preservation therapy，multiple pregnancies，low selenium intake，low zinc intake and multiparous were the main risk factors for intrahepatic cholestasis of pregnancy.