Cholesterol doesn’t have the same clout as plenty of other heart-related biomarkers. You can’t check the amount of cholesterol (a.k.a. a waxy fat made by your liver) floating in your blood using a wearable, like you can your heart rate or blood pressure. And even if you pay your doctor a yearly visit (kudos!), they probably aren’t running a blood test for cholesterol unless you’re at high risk for heart disease, for instance due to a family history. But based on new research being presented this weekend at an American College of Cardiology conference, it’s also key to know your cholesterol levels if you’re trying to conceive or even planning to become pregnant in the near future, as elevated numbers could raise your risk of pregnancy complications and heart issues in the years just following.
Drawing from a database of electronic medical records, researchers compared more than 10,000 pregnant women who had a documented history of high cholesterol at least a year before their delivery date with a similarly large group of pregnant women who had no such history. And when they controlled for a handful of variables (like age and health conditions), they found that the women with the pre-pregnancy high cholesterol were significantly more likely than their normal-cholesterol peers to wind up with gestational diabetes, hypertensive disorders of pregnancy (conditions involving high blood pressure, like preeclampsia), hemorrhage during pregnancy, and labor and delivery complications, as well as arrhythmia (a.k.a. irregular heartbeat) and heart attack within just five years postpartum.
It’s the immediacy of these negative effects that’s notable, according to Mahathi Indaram, MD, a board-certified cardiologist at the Allegheny Health Network Cardiovascular Institute, in Pittsburgh, and an author on the study. We’ve long known that hyperlipidemia, or high cholesterol, is a big risk factor for heart disease in the general population, but we haven’t had good data for pregnant people, she says. After all, normal hormonal changes of pregnancy cause cholesterol levels to rise, so health care providers don’t typically test during this period. Hence why Dr. Indaram wanted to investigate what might happen to those who are already walking around with high cholesterol when they get pregnant—which is, in itself, a stressor to the heart. It turns out, the combination doesn’t just raise your risk of pregnancy complications; it may fast-track your path to the kinds of heart conditions typically caused by high cholesterol much later in life.
Why having high cholesterol before getting pregnant can raise your risk of complications and postpartum heart issues
Though this study didn’t explore exactly why pre-pregnancy high cholesterol contributes to negative pregnancy outcomes and heart-related fallout, we know from prior research that a healthy pregnancy hinges on a robust heart and cardiovascular system. Extra cholesterol could get in the way of that by contributing to the formation of waxy plaques in your arteries, which can slow blood flow to your heart, Srijana Maharjan, MD, the lead author of the study and an internal medicine resident at Allegheny General Hospital, in Pittsburgh, tells SELF. There’s also the highly inflammatory nature of excess cholesterol, Dr. Indaram adds, which can damage the lining of your blood vessels, further threatening your heart health.
Think of a cholesterol surplus as essentially piling onto the additional strain that your heart will bear just by nature of being pregnant. It’s the reason research also suggests having other cardiovascular risk factors when you enter pregnancy, like high blood pressure or high blood sugar levels, may bump up your risk of negative obstetric and heart outcomes too.
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