**Core Concept**
Cholestasis of pregnancy is a liver disorder that occurs during pregnancy, characterized by a reduction in bile flow and elevation of bile acids in the blood. It is a complication of intrahepatic cholestasis, which can lead to pruritus, jaundice, and increased risk of fetal distress.

**Why the Correct Answer is Right**
Cholestasis of pregnancy is associated with an increased risk of preterm labor and fetal distress due to the high levels of bile acids in the maternal bloodstream. Bile acids can cross the placenta and stimulate the fetal heart, leading to tachycardia and potential fetal compromise. The exact pathophysiology is not fully understood, but it is believed to involve a genetic predisposition, hormonal changes, and altered bile acid metabolism.

**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect because pruritus is a hallmark symptom of cholestasis of pregnancy, occurring in up to 90% of patients.
**Option B:** This option is incorrect because elevated bile acids in the maternal bloodstream are a key feature of cholestasis of pregnancy, leading to increased risk of fetal distress.
**Option C:** This option is incorrect because cholestasis of pregnancy is associated with an increased risk of preterm labor and fetal distress, not a decreased risk.

**Clinical Pearl / High-Yield Fact**
The diagnosis of cholestasis of pregnancy is clinical, and laboratory tests are supportive. A key mnemonic to remember is "PRICKLE," which stands for Pruritus, Right upper quadrant pain, Increased bile acids, Cholestasis, Liver enzymes, Ketosis, and Electrolyte imbalance.

**Correct Answer:** C.