Objective To investigate the relationship between changes in the ratio of total bilirubin (TBIL), direct bilirubin (DBIL) and perinatal maternal, infant outcomes in pregnant women with intrahepatic cholestasis. Methods From January 2012 to August 2017, 100 pregnant women with intrahepatic cholestasis treated in Shengjing Hospital affiliated to China Medical University were selected as the research objects. According to the ratio of DBIL and TBIL in pregnant women, they were divided into observation group I (DBIL/TBIL: 0.50 to 0.75) and observation group II (DBIL/TBIL: > 0.75), 50 cases in each group; 50 healthy mothers during the same period were used as the control group. TBil, DBil, bile acid (TBA) levels and outcomes of maternal and child were recorded. Results The serum levels of TBIL and DBIL in group II were higher than those in observation group I and the control group, and the differences were statistically significant (P?