How do cholesterol levels affect pregnancy?

By (embryologist), (gynecologist) and (psychologist).
Last Update: 01/23/2022

Cholesterol is a necessary lipid in our body, although it is often considered harmful. This molecule is present in cell membranes and is also important for the production of bile acids (which digest fats) and other molecules such as certain hormones.

Thus, cholesterol plays an important role in fertility and pregnancy, as it is the precursor of steroid hormones including estrogens, androgens, and progestogens.

Normal cholesterol levels

Although cholesterol is synthesized in the liver, the cholesterol we ingest through our diet also contributes to the total values.

Therefore, to know the cholesterol levels, they can be evaluated by a blood test. Normally, three parameters will appear in the results of this test:

  • Total cholesterol. It must be less than 200 mg/dl.
  • LDL. It refers to low-density lipoproteins, the "bad cholesterol", and should be below 100 mg/dl.
  • HDL. These are high-density lipoproteins or "good cholesterol" and ideally should be greater than 35 mg/dl in men and 40 mg/dl in women.

These lipoproteins are responsible for transporting cholesterol in the blood. LDL transports cholesterol from the liver to the tissues, while HDL takes the reverse route.

Cholesterol in pregnancy

When a woman is pregnant, cholesterol levels rise above the values considered normal for a non-pregnant adult woman.

This increase is more noticeable once the first trimester of pregnancy has passed, due to the hormonal and metabolic changes that women experience during gestation. However, high cholesterol during pregnancy should naturally decrease shortly after delivery.

However, it is common that cholesterol levels are not strictly controlled in pregnant women and, therefore, there is no range that establishes normal cholesterol values during pregnancy.

High cholesterol before pregnancy

In spite of what we have just mentioned, a greater follow-up is performed if the pregnant woman had a high cholesterol problem (hypercholesterolemia) prior to becoming pregnant.

Therefore, it is necessary for a woman who already knows she has a high cholesterol problem to consult with her physician at the time she wants to seek gestation. Thus, the specialist will be able to control your cholesterol levels, assess whether it is necessary to replace your treatment with another medication during pregnancy and carry out an appropriate follow-up.

One of the main reasons is that statins, a very common type of cholesterol-lowering drug, are not considered appropriate during pregnancy and lactation. Because of this, the woman should stop this treatment even about two months before becoming pregnant or, failing that, when she becomes aware of the pregnancy.

Risks of high cholesterol in pregnancy

As we have mentioned, it is completely normal for cholesterol levels to increase during pregnancy, especially from the first trimester onwards.

However, if cholesterol is excessively elevated, it may be related to an increased risk of certain pregnancy complications. Among them, we can mention the following:

In addition, high cholesterol during pregnancy may be associated with certain complications for the offspring, such as elevated LDL cholesterol levels or increased severity of myocardial infarction.

Therefore, it is important to monitor cholesterol levels during pregnancy and adopt habits that help to keep them under control.


To prevent cholesterol levels from increasing to undesirable levels during pregnancy, pregnant women should keep the following recommendations in mind:

  • Follow a balanced, varied diet, rich in fiber and low in saturated fats. Fat intake should come from healthy sources, such as fish, nuts and olive oil.
  • Exercise adapted to pregnancy.

However, it is important to mention that it is also not ideal to have low cholesterol levels during pregnancy, as it is a molecule necessary for growth and for the development of fetal organs.

FAQs from users

Is it dangerous to have cholesterol above 300 in pregnancy?

By Xinxin Lin MD (gynecologist).

It has been proposed that elevated cholesterol levels may cause damage to the fetal blood vessels, leading to a predisposition to develop cholesterol problems, arteriosclerosis, and cardiovascular pathologies in the future.
Read more

How should cholesterol levels be in the third trimester of pregnancy?

By Silvia Azaña Gutiérrez B.Sc., M.Sc. (embryologist).

Normally, in the second trimester of pregnancy, cholesterol levels begin to increase above levels considered normal for a woman who is not pregnant. Therefore, in the third trimester of pregnancy, cholesterol values will be increased.

This rise in cholesterol levels is considered physiological during pregnancy. However, if cholesterol values increase excessively, pregnancy complications such as preeclampsia, preterm delivery and gestational diabetes may be associated with it.

Do I have to lower my cholesterol levels to get pregnant?

By Silvia Azaña Gutiérrez B.Sc., M.Sc. (embryologist).

It is advisable for cholesterol levels to be at adequate levels, both for seeking a pregnancy (either naturally or through assisted reproduction techniques) and for other important aspects such as having a good cardiovascular health.

In addition, if cholesterol levels are elevated in women, the time to achieve a pregnancy may be longer than if the levels are adequate.

Therefore, the best thing to do is to try to reduce cholesterol levels with a healthy and varied diet, avoiding bad habits such as smoking and exercising frequently.

Is treatment for high cholesterol necessary during pregnancy?

By Silvia Azaña Gutiérrez B.Sc., M.Sc. (embryologist).

It will depend on the situation. Patients with high cholesterol prior to becoming pregnant should discontinue treatment if they are taking statins, since their use is not recommended during pregnancy.

However, since cholesterol levels increase during pregnancy, it will be convenient to control their values, either by means of a healthy diet low in saturated fats or, if the specialist considers it appropriate, with the help of a recommended drug.

If you are pregnant, you may want to get information about vitamins to take during pregnancy. To do so, you can visit the following link: What vitamins to take during pregnancy?

On the other hand, you may also be interested in the food you should eat while breastfeeding. In this case, we recommend that you read the following article: Feeding and nutrition of the mother during lactation

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FAQs from users: 'Is it dangerous to have cholesterol above 300 in pregnancy?', 'How should cholesterol levels be in the third trimester of pregnancy?', 'Do I have to lower my cholesterol levels to get pregnant?' and 'Is treatment for high cholesterol necessary during pregnancy?'.

Read more

Authors and contributors

 Silvia Azaña Gutiérrez
Silvia Azaña Gutiérrez
B.Sc., M.Sc.
Graduate in Health Biology from the University of Alcalá and specialized in Clinical Genetics from the same university. Master in Assisted Reproduction by the University of Valencia in collaboration with IVI clinics. More information about Silvia Azaña Gutiérrez
License: 3435-CV
 Xinxin Lin
Xinxin Lin
Dr. Xinxin Lin has a degree in Medicine from the University of Barcelona and is a specialist in gynecology and assisted reproduction. More information about Xinxin Lin
Colleague number: 48324
Adapted into english by:
 Cristina  Algarra Goosman
Cristina Algarra Goosman
B.Sc., M.Sc.
Graduated in Psychology by the University of Valencia (UV) and specialized in Clinical Psychology by the European University Center and specific training in Infertility: Legal, Medical and Psychosocial Aspects by University of Valencia (UV) and ADEIT.
More information about Cristina Algarra Goosman
Member number: CV16874

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