Maternal Hypertension and Fecundability: A Population-Based Cohort Study.

Area of Science:

• Reproductive Health
• Cardiovascular Health
• Epidemiology

Background:

• The relationship between maternal hypertension and fecundability remains unclear.
• Hypertension affects a significant portion of women of reproductive age.
• Understanding this association is crucial for preconception care.

Purpose of the Study:

• To investigate the association between preconception hypertension and fecundability.
• To determine if blood pressure control mitigates the risk of reduced fecundability in hypertensive women.

Main Methods:

• Prospective cohort study involving 1422 couples with hypertensive female partners and 997,703 reference couples.
• Fecundability assessed by time to pregnancy (TTP) and infertility (TTP >12 months).
• Analyses included instrumental variable, propensity score matching, and inverse probability of treatment weighting.

Main Results:

• Maternal hypertension, both controlled and uncontrolled, was associated with prolonged TTP and increased infertility risk.
• Instrumental variable analyses showed no significant association between blood pressure control and TTP or infertility.
• Findings were consistent across different analytical methods.

Conclusions:

• Maternal hypertension is an independent risk factor for prolonged time to pregnancy and infertility.
• Blood pressure control did not significantly alter the association between hypertension and fecundability in this study.
• Results support preconception hypertension screening and inform future research designs.