近年來婦女肥胖以及代謝症候群盛行率增加，加上第一次懷孕年齡逐漸往後，在年齡稍長的孕婦合併有高血脂症者並不少見。目前已經知道有肥胖、糖尿病、高血脂等代謝異常的懷孕婦女，會增加生產期間的併發症。而母體的高血脂與早產、胎兒體重過輕或過重，甚至將來長大後罹患心血管疾病的風險都有相關。懷孕期間母體荷爾蒙改變，血脂肪本來就會生理性升高以提供正常胚胎發育，因此孕期血脂異常目前似乎並沒有很明確的定義。孕期嚴重高膽固醇或高三酸甘油脂的案例，多發生於家族性血脂異常的患者。臨床上這些患者在懷孕前，醫師有必要提醒患者相關的風險，提早預防後續造成相關的併發症。同時，高齡懷孕婦女日漸增多，有些婦女早就知道自己有高血脂，甚至有些婦女在受孕前已經在服用降血脂藥物。本篇將討論孕期高血脂對懷孕的影響，以及懷孕併發高血脂症時可能選擇的醫療處置。

As the age of mother with first pregnancy became older, the prevalence of obesity and metabolic syndrome increases. In such women, hyperlipidemia are not uncommon during pregnancy. The risk of complicated pregnancy as well as the perinatal complications of their offspring increases. For example, hyperlipidemia may increase the risk of preeclampsia and acute pancreatitis during pregnancy. Dyslipidemia in pregnancy also increase the risk of premature birth, fetal underweight or overweight; and the offspring of mother with dyslipidemia in pregnancy have higher risk of cardiovascular diseases when they grew up. Due to the physiological hormonal changes, blood lipid level would raise to support normal embryonic development during pregnancy; so dyslipidemia during pregnancy does not seem to have a very clear definition. However, severe cases of high cholesterol or triglyceride during pregnancy often indicates familial dyslipidemia. Clinically, proper patient education should be implemented before these patients became pregnant; doctors need to remind their patients about the risks, and do early prevention for related complications. At the same time, the increasing number of pregnancy in women with advanced age indicates that some of these women already know that they have hyperlipidemia, and some of them may already been taking lipid-lowering agents before they become pregnant. Most of the cholesterol-lowering drugs should not be used during pregnancy; therefore for obesity, diabetes and/or dyslipidemia pregnant women, diet control, exercise and weight control should be the main mandates. This article will discuss the impact of high blood lipids during pregnancy, and how to manage. (J Intern Med Taiwan 2017; 28: 287-297)