Impact of Hypercholesterolemia on Pregnancy and Postpartum

Cardiovascular disease (CVD) is a leading cause of maternal mortality and is secondary to the rising rates of prepregnancy CVD risk factors. Pregnancy represents a unique physiologic state characterized by significant alterations in lipid metabolism, which supports placental steroidogenesis and fetal growth. This article reviews the physiology of lipid metabolism in pregnancy, the pathophysiologic mechanisms linking dyslipidemia to adverse maternal and fetal outcomes, and current evidence guiding clinical management throughout gestation and the postpartum period. Emphasis is placed on risk stratification, medication safety, monitoring strategies, and long-term cardiovascular implications, with the goal of integrating lipid management into contemporary cardio-obstetric care.