Normal, Low and High Cholesterol Levels During Pregnancy

Cholesterol is an organic molecule derived from fats and is present in every cell in our body. Physically, it looks like a waxy, soft, yellow-tinted substance. Cholesterol is required in the production of bile salts, several hormones, including testosterone and oestrogen, and Vitamin D. It is transported through the blood with the help of small carriers known as lipoproteins. Around seventy-five per cent of cholesterol is produced in the body itself, with the remaining obtained from the food we eat. Pregnant women are generally required to be more careful about their diets; this includes managing cholesterol levels in the body. Cholesterol can be high during pregnancy as the body naturally supports the baby’s development. This article will help you understand the variations in cholesterol levels in the body during pregnancy, the importance of cholesterol in the development of the foetus, and how to control the risks associated with raised cholesterol in pregnancy.

What Is the Normal Cholesterol Level in Pregnancy?

The cholesterol ranges for adults are given below:

• The normal cholesterol range for an adult is below 2 mg/mL but ideally between 1.2 and 1.9 mg/mL.
• In the first trimester of pregnancy, the cholesterol levels can range between 1.4 and 2.2 mg/mL.
• In the second trimester of pregnancy, the cholesterol levels can range between 1.8 and 3 mg/mL.
• In the third trimester of pregnancy, the cholesterol levels can range between 2.2 and 3.5 mg/mL.

Does Cholesterol Level Change When Pregnant?

As you can see, the later you are in your pregnancy, the higher your cholesterol levels. However, there is nothing to be concerned about, as this increase is quite natural and is essential for the baby’s growth. Under standard conditions, your blood cholesterol will be highest just before you give birth, with a sharp decline immediately after delivery. This drop is more significant when you begin breastfeeding your newborn, as cholesterol is utilised in the production of breast milk.

How Common Is High Cholesterol in Pregnant Women?

High cholesterol has a different meaning when it comes to pregnant women. Anything between 2 and 3.5 mg/mL is considered dangerous for most adults but completely acceptable during pregnancy. Further, the foetus begins to produce cholesterol of its own, increasing the overall cholesterol levels in the mother’s bloodstream.

What Causes High Cholesterol During Pregnancy?

Elevated cholesterol in pregnancy plays several roles in foetal growth. For instance, cholesterol regulates sex hormone synthesis, which is required in taking your pregnancy to term. Further, cholesterol is required in the cellular, organ, limb and brain development of the foetus.

Signs and Symptoms of High Cholesterol

In almost all cases, you will observe no external signs and symptoms, and your pregnancy will proceed according to plan. Nevertheless, there is a small likelihood of your cholesterol levels exceeding the maximum permissible limits and remain there for extended periods of time. In these cases, there is a higher risk of complications like strokes and heart attacks. This is because excess cholesterol can build up in the artery walls, impairing blood circulation. This condition is known as atherosclerosis.

How Can High Cholesterol Level Be Detected?

Most doctors don’t pay attention to cholesterol levels during pregnancy. This might make you nervous, but the standard procedure is testing cholesterol levels at least four to six weeks after delivery. It’s important to understand what is the normal range of cholesterol during pregnancy. However, your doctor will ensure that your lipoprotein is balanced, with a high high-density lipoprotein count and a low low-density lipoprotein count. If you are concerned about your cholesterol levels or have a family history of atherosclerosis, ask your doctor for regular blood tests for supervision.

Can High Cholesterol Be Dangerous in Pregnancy?

Risks associated with high cholesterol during pregnancy include the development of pregnancy-induced hypertension, which means the increased blood pressure can harm both your life and your baby. Hypertension can increase the likelihood of other complications like postpartum stroke, heart attacks, atherosclerosis, preeclampsia, seizures, premature delivery, and so on. Genetic disorders like Familial Hypercholesterolemia, caused by a defect on chromosome 19, prevent the body from removing low-density lipoprotein cholesterol from the blood. This makes cholesterol base levels much higher than normal, leading to dangerous complications during pregnancy. Further, several studies have shown that babies born to mothers who had high cholesterol levels during pregnancy are five times as likely to develop cholesterol-related conditions when they are adults.

Ways of Treating High Cholesterol During Pregnancy

It is strongly recommended to avoid any cholesterol-controlling medication during your pregnancy, as cholesterol is quite essential for the process. Doctors only prescribe these medications, such as Atorvastatin, if your cholesterol levels do not reduce after delivery. However, you might experience a few side effects, such as headaches and rashes.

How Can You Prevent High Cholesterol When Pregnant?

Some simple ways of preventing high cholesterol during pregnancy include:

1. Eat Fibre

The fibre found in many fruits, whole grains, and vegetables are essential in a balanced diet. In addition, both soluble and insoluble fibre has proven to lower cholesterol levels in both pregnant and non-pregnant patients.

2. Control Fat Intake

Before reducing your fat intake, please consult your doctor. They will be able to recommend the minimum amount of fat consumption required per day for the neurological development of your foetus. Consume healthy sources of fat such as nuts, olive oil, fish, flaxseed oil, and so on.

3. Exercise Regularly

Newer studies are showing that active women, especially during the first trimester, have lower levels of cholesterol than those with a sedentary lifestyle. Exercising before pregnancy will help you continue doing the same during pregnancy. Please ensure you only do mild to moderate exercises to avoid stressing your heart. These include low-impact cardio exercises like treadmills and stationary bicycles. Even daily activities like walking, going up stairs, gardening, and so on can help reduce low-density lipoprotein while increasing high-density lipoprotein cholesterol.

4. Stay Hydrated

Drink enough water, especially if you are exercising regularly. This is because dehydration can lead to an increase in low-density lipoprotein. Avoiding refined sugar and caffeine can help reduce the levels of triglycerides during pregnancy, which in turn lowers cholesterol levels.

5. Live Healthily

Healthy living includes both a balanced diet as well as avoiding tobacco and alcohol during pregnancy, as the latter can worsen any complications brought on by high cholesterol levels. Staying stress-free by doing simple breathing exercises, meditation, and yoga can influence a healthy pregnancy.

Low Cholesterol Levels During Pregnancy

High cholesterol levels can be harmful during pregnancy, and the same applies to low cholesterol levels. Low cholesterol levels, that is less than 1 g/mL, can lead to pregnancy problems like preterm labour, premature birth and so on. Since cholesterol is essential in the formation of healthy placental tissue, insufficient amounts can affect foetal development, which can cause a smaller baby head circumference, low birth weight, among others.

When to Consult the Doctor

You should consult a doctor concerning cholesterol levels during pregnancy if:

• Cholesterol levels rise significantly: If routine blood tests show a dramatic increase in cholesterol, even though some rise is expected during pregnancy, a doctor can provide guidance.
• There’s a family history of cholesterol problems: If high cholesterol, heart disease, or other lipid disorders run in your family, it’s important to consult your doctor to monitor levels closely.
• There is pre-existing high cholesterol: If you had elevated cholesterol levels before pregnancy, regular medical supervision is necessary to manage risks for both you and the baby.
• There are symptoms like chest pain or breathlessness: Even if your cholesterol levels are not extremely high, symptoms like chest pain, difficulty breathing, or dizziness warrant medical advice.
• There’s a concern about diet and lifestyle adjustments: If you’re unsure whether your current diet or exercise routine is sufficient to manage cholesterol or if your efforts are ineffective, a doctor can recommend alternative approaches or medications.

FAQs

1. How can cholesterol levels affect the placenta’s function during pregnancy?

Elevated cholesterol levels can potentially impact the placenta’s ability to supply nutrients and oxygen to the baby, which may lead to complications such as preeclampsia or restricted fetal growth.

2. Are there specific types of cholesterol that are more concerning during pregnancy?

While both LDL (low-density lipoprotein) and HDL (high-density lipoprotein) cholesterol levels are monitored, unusually high LDL levels are particularly concerning as they may increase the risk of cardiovascular issues for the mother.

3. Can cholesterol levels during pregnancy influence the baby’s long-term health?

Elevated maternal cholesterol levels have been associated with a higher risk of the baby developing metabolic disorders later in life, including obesity and diabetes.

4. What impact does gestational diabetes have on cholesterol levels during pregnancy?

Gestational diabetes can lead to changes in lipid metabolism, which might exacerbate cholesterol levels and complicate cholesterol management during pregnancy.

This was all about cholesterol and pregnancy. High cholesterol levels are important for a successful pregnancy and often fall in the first month or so after delivery. However, if you have a predilection for cholesterol-related conditions, it is important to consult your doctor for treatment. Finally, please make sure you consume a balanced diet combined with exercise, adequate sleep, and hydration, as this takes care of most pregnancy requirements.

References/Resources:

1. Wild. R, Feingold. K; Effect of Pregnancy on Lipid Metabolism and Lipoprotein Levels; National Library of Medicine; https://www.ncbi.nlm.nih.gov/books/NBK498654/

2. Bartels. Ä, O’Donoghue. K; Cholesterol in pregnancy: a review of knowns and unknowns (Obstetric Medicine); National Library of Medicine; https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4989641/; December 2011

3. Mehta. L, Warnes. C, Bradley. E, Burton. T, Economy. K, et al.; Cardiovascular Considerations in Caring for Pregnant Patients: A Scientific Statement From the American Heart Association; American Heart Association; https://www.ahajournals.org/doi/10.1161/CIR.0000000000000772; May 2020

4. Alston. M, Redman. L, Sones. J; An Overview of Obesity, Cholesterol, and Systemic Inflammation in Preeclampsia; MDPI; https://www.mdpi.com/2072-6643/14/10/2087; May 2022

5. High Cholesterol (Mother to Baby); National Library of Medicine; https://www.ncbi.nlm.nih.gov/books/NBK582749/; August 2022

6. Chang. J, Chen. Y, Chen. I, et. al.; Perinatal Outcomes After Statin Exposure During Pregnancy; JAMA Network; https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2787600; December 2021

7. Cholesterol test; Mayo Clinic; https://www.mayoclinic.org/tests-procedures/cholesterol-test/about/pac-20384601

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