Leisure Physical Activity, Sedentary Behavior, and Cardiovascular Health 2-7 yr after Pregnancy in the nuMoM2b Heart Health Study Cohort.

Abstract

This study aimed to evaluate whether higher moderate- to vigorous-intensity physical activity (MVPA) and lower sedentary behavior (SB) are related to better cardiovascular health (CVH) after pregnancy. In the nuMoM2b Heart Health Study cohort, Life's Essential 8 health factors (body mass index [BMI], blood pressure, glucose, and lipids) were assessed in the first trimester of pregnancy and 2-7 yr later ( n = 3985). The four health factors were scored with Life's Essential 8 criteria (0 = poorest; 100 = ideal) and averaged to calculate a CVH health factor score (CVH hf) . Self-reported leisure MVPA and SB were assessed at follow-up. Linear regression evaluated associations of MVPA levels and SB quartiles with follow-up CVH hf after adjustment for first trimester CVH hf and covariates. Analyses were repeated after stratification by history of hypertensive disorders of pregnancy (HDP) or gestational diabetes (GDM). Over follow-up (mean 3.2 yr after delivery), CVH hf declined from 85.6 to 81.6 points (-4.0 points, P < 0.001). The decline was greatest in lipid (-8.4 points, P < 0.001) and BMI scores (-5.6 points, P < 0.001). Healthier activity profiles (higher MVPA level and lower SB quartile) were each associated with higher CVH hf at follow-up: 0.7 points higher per level of MVPA, P < 0.001; 0.5 points lower per quartile of SB, P = 0.0042. Higher MVPA level associated with healthier BMI, glucose, and lipid scores; lower SB quartile associated with healthier BMI and blood pressure scores ( P < 0.05). Although HDP/GDM history was associated with lower CVH hf , patterns of CVH hf across healthier leisure MVPA levels and SB quartiles were similar in those with and without HDP or GDM. Higher MVPA and lower SB during leisure could help to maintain CVH health factors in the years after pregnancy, including among those who experienced HDP or GDM.