Maternal physiological hypercholesterolemia (MPH; total cholesterol (TC)≤280 mg/dL) occurs during pregnancy to support fetal growth. When TC exceeds this threshold, this condition is recognized as maternal supraphysiological hypercholesterolemia (MSPH), which is associated with endothelial dysfunction in the maternal and fetoplacental vasculature. Placenta-derived extracellular vesicles (EVs), which mediate intercellular communication during pregnancy, may contribute to MSPH by affecting endothelial cells.