Higher blood pressure during preconception was also associated with a decrease in the chance of live birth, but this association disappeared after adjusting for other confounders.
The study also examined the relationship between preconception blood pressure and the probability of conception. While the unadjusted models suggested 10% lower odds of fecundability, adjusting for all covariates except for BMI found similar effect estimates.
“We observed no clear associations of preconception blood pressure with fecundability after adjustment for BMI, suggesting that pathways related to BMI, which is strongly related to fecundability, may explain the marginal association of blood pressure with fecundability,” the authors wrote.
There was also some evidence that aspirin may influence the association between higher preconception blood pressure and pregnancy loss, as this association was marginally stronger in the placebo group than in the group randomized to low-dose aspirin.
“Pregnancy loss and other adverse reproductive outcomes may serve as sensitive markers of early-stage progression toward cardiometabolic disease in young adults,” Dr. Noble and coauthors wrote. “Further elucidating the cardiometabolic risk factors for pregnancy loss may help identify early intervention strategies, such as regular physical activity and following a DASH-type (Dietary Approaches to Stop Hypertension) diet.”
The study was supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development. No conflicts of interest were declared.
SOURCE: Nobles CJ et al. Hypertension. 2018 Apr 2;71. doi: 10.1161/hypertensionaha.117.10705.