Elevations in the cholesterol profiles of non-pregnant individuals are a cause for medical attention due to the health complications associated with high cholesterol. Current research suggests that during a normal pregnancy cholesterol levels increase, but the nature and extent of the increase are not well described. In pregnancy, this elevation is considered normal and does not alarm medical personnel or require medical intervention. Although this rise in lipids does not yet warrant great concern, research has yet to agree on the reasons for, and effects of, this change. This systematic analysis reviews the literature on maternal cholesterol and cholesterol sub-fractions and their changes in pregnancy, focusing on total cholesterol, low density lipoprotein cholesterol and high density lipoprotein cholesterol. In 21 studies, the average increase in total cholesterol from the first to third trimester was 46% and in low density lipoprotein cholesterol a 60% increase was observed, both peaking in the third trimester. However, high density lipoprotein cholesterol levels only increased 10% on average and peaked during the second trimester. Theories about this increase in cholesterol, and areas for future research are also discussed. There is insufficient understanding of the role of cholesterol in pregnancy, making it difficult to define target cholesterol levels during pregnancy. Further research is needed to help researchers better understand the mechanism behind pregnancy cholesterol changes and health complications that may result from abnormal levels.
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