High cholesterol living in pregnancy

Overview

High cholesterol means you have too much of a fatty substance called cholesterol in your blood. During pregnancy, cholesterol levels naturally go up to help the baby grow. But if levels get too high, it can increase the risk of problems for you and your baby.

Yes, high cholesterol is common during pregnancy because the body naturally makes more to support the baby. Most women have higher cholesterol, but only some have levels that are concerning.

It affects pregnant women, especially those who already had high cholesterol before pregnancy, or those who have conditions like diabetes or obesity. It can affect women of any age or background.

Symptoms

Common symptoms

• High cholesterol usually has no symptoms on its own.
• You may have symptoms of related conditions, like high blood pressure (headaches, blurred vision).

Causes

Main causes

• Pregnancy itself causes the liver to produce more cholesterol to make hormones for the baby.
• In some women, the body makes too much cholesterol or does not remove it properly.
• Genetics can play a role – some people have a condition called familial hypercholesterolemia that causes very high cholesterol.

Risk factors

• Having high cholesterol before pregnancy
• Being overweight or obese before pregnancy
• Having diabetes or gestational diabetes
• Eating a diet high in saturated fats and low in fiber
• Not being physically active
• Smoking or drinking alcohol during pregnancy

When to see a doctor

See a doctor urgently if:

• If you have any emergency symptoms listed above, call your local emergency number immediately.
• If you have a very high blood pressure reading or severe headache, see a doctor right away.

Book a routine appointment if:

• Your midwife or doctor will check your cholesterol as part of routine blood tests in early pregnancy.
• If you have risk factors, you may be monitored more often.

Diagnosis

Your doctor or midwife will take a blood sample to measure your total cholesterol, 'bad' LDL cholesterol, and 'good' HDL cholesterol. This is usually done in early pregnancy as part of routine screening.

Tests that may be done

• Blood test (lipid panel)

What to expect at your appointment

The test is a simple blood draw, usually from your arm. It's quick and you don't need to fast unless your doctor asks. Results come back in a few days.

Treatment

Treatment focuses on lifestyle changes because many cholesterol-lowering medications are not safe during pregnancy. Your doctor will help you manage your cholesterol to keep you and your baby healthy.

Self-care at home

• Eat a healthy diet with lots of fruits, vegetables, whole grains, and lean proteins.
• Avoid fried foods, fatty meats, and processed snacks.
• Stay active with walking or pregnancy-safe exercises (ask your doctor first).
• Do not smoke or drink alcohol during pregnancy.
• Manage your weight gain within the recommended range.

Medical treatments

If your cholesterol is very high or you have other risks like diabetes, your doctor may recommend a medication that is considered safe during pregnancy. These are usually bile acid sequestrants or other drugs that don't cross the placenta. Never take any cholesterol medication without your doctor's advice.

Living with this condition

Living with high cholesterol during pregnancy means paying extra attention to your diet and activity. Most women manage it well with healthy habits and regular check-ups.

Lifestyle tips

• Eat more oats, beans, nuts, and oily fish (like salmon) in moderation.
• Choose unsaturated fats like olive oil over butter.
• Limit sugary drinks and sweets.
• Get at least 150 minutes of moderate activity per week (like brisk walking).
• Monitor your blood pressure if advised by your doctor.

Diet and exercise

A heart-healthy diet and regular exercise are the main ways to manage cholesterol during pregnancy. Include plenty of fiber from fruits, vegetables, and whole grains. Aim for 30 minutes of gentle exercise most days, but always check with your doctor first.

Mental health and emotional wellbeing

Worrying about your cholesterol or the health of your baby can cause stress and anxiety. It's important to talk to your midwife or doctor if you're feeling overwhelmed. They can refer you to a counselor or support group.

Prevention

You can reduce your risk of very high cholesterol by maintaining a healthy weight, eating well, and staying active before and during pregnancy. However, some increase is normal and unavoidable.

Screening programmes

Routine blood tests in pregnancy will check your cholesterol levels. If you have family history of high cholesterol or heart disease, you may be offered earlier screening.

Complications

If left untreated

• Pre-eclampsia (dangerously high blood pressure during pregnancy)
• Gestational diabetes
• Premature birth (baby born too early)
• Low birth weight

Long-term outlook

For most women, high cholesterol during pregnancy is temporary and returns to normal after birth. With a healthy lifestyle and regular medical care, you can keep risks low and have a healthy pregnancy and baby.

Find support

Local organisations

• NHS ↗ · United Kingdom

Helplines

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