Pregnancy induces significant physiological changes in lipid metabolism, leading to increased levels of total cholesterol, LDL-cholesterol, triglycerides, and decreased HDL-cholesterol. These changes are more pronounced in women with familial hypercholesterolemia (FH), who have higher baseline lipid levels and experience greater increases during pregnancy. A more atherogenic lipid profile during pregnancy is associated with adverse outcomes for both mother and child, including preeclampsia, gestational diabetes, preterm birth, and unfavorable lipid profiles. Early pregnancy lipid screening could help identify at-risk individuals and enable early intervention. Dyslipidemia during pregnancy is linked to long-term cardiovascular risks for both mother and child. Women with FH are particularly vulnerable due to their higher lipid levels and the prolonged discontinuation of lipid-lowering therapy during pregnancy and breastfeeding. Gestational lipid screening in the first trimester may provide valuable insights into future cardiovascular risks and help in early prevention. Future research should focus on the implementation of gestational lipid screening and its impact on cardiovascular risk prevention for both mother and child. The study highlights the importance of understanding lipid metabolism during pregnancy and its implications for maternal and fetal health.Pregnancy induces significant physiological changes in lipid metabolism, leading to increased levels of total cholesterol, LDL-cholesterol, triglycerides, and decreased HDL-cholesterol. These changes are more pronounced in women with familial hypercholesterolemia (FH), who have higher baseline lipid levels and experience greater increases during pregnancy. A more atherogenic lipid profile during pregnancy is associated with adverse outcomes for both mother and child, including preeclampsia, gestational diabetes, preterm birth, and unfavorable lipid profiles. Early pregnancy lipid screening could help identify at-risk individuals and enable early intervention. Dyslipidemia during pregnancy is linked to long-term cardiovascular risks for both mother and child. Women with FH are particularly vulnerable due to their higher lipid levels and the prolonged discontinuation of lipid-lowering therapy during pregnancy and breastfeeding. Gestational lipid screening in the first trimester may provide valuable insights into future cardiovascular risks and help in early prevention. Future research should focus on the implementation of gestational lipid screening and its impact on cardiovascular risk prevention for both mother and child. The study highlights the importance of understanding lipid metabolism during pregnancy and its implications for maternal and fetal health.