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. 2025 Feb 3.
doi: 10.1249/MSS.0000000000003660. Online ahead of print.

Leisure Physical Activity, Sedentary Behavior, and Cardiovascular Health 2-7 Years after Pregnancy in the nuMoM2b HHS Cohort

Bethany Barone Gibbs  1 , Sarah Modlin  1 , Noel Bairey Merz  2 , David M Haas  3 , Sadiya S Khan  4 , Abbi Lane  5 , Rebecca B McNeil  6 , Jasmina Varagic  7 , Kimberly Huber  8 , Ligia Vasquez-Huot  3 , Janet M Catov  8 ; National Heart, Lung, and Blood Institute nuMoM2b Heart Health Study Network
Affiliations

Leisure Physical Activity, Sedentary Behavior, and Cardiovascular Health 2-7 Years after Pregnancy in the nuMoM2b HHS Cohort

Bethany Barone Gibbs et al. Med Sci Sports Exerc. .

Abstract

Purpose: To evaluate whether higher moderate-to-vigorous intensity physical activity (MVPA) and lower sedentary behavior (SB) are related to better cardiovascular health (CVH) following pregnancy.

Methods: In the nuMoM2b Heart Health Study (HHS) cohort, Life's Essential 8 health factors (BMI, blood pressure, glucose, and lipid) were assessed in the first trimester of pregnancy and 2-7 years later (n = 3,985). 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 (CVHhf). Self-reported leisure MVPA and SB were assessed at follow-up. Linear regression evaluated associations of MVPA levels and SB quartiles with follow-up CVHhf after adjustment for first trimester CVHhf and covariates. Analyses were repeated after stratification by history of hypertensive disorders of pregnancy (HDP) or gestational diabetes (GDM).

Results: Over follow-up (mean 3.2 years after delivery), CVHhf 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 CVHhf 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 CVHhf, patterns of CVHhf across healthier leisure MVPA levels and SB quartiles were similar in those with and without HDP or GDM.

Conclusions: Higher MVPA and lower SB during leisure could help to maintain CVH health factors in the years following pregnancy, including among those who experienced HDP or GDM.

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Conflict of interest statement

Conflict of Interest and Funding Source: Grant funding from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD): U10 HD063036; U10 HD063072; U10 HD063047; U10 HD063037; U10 HD063041; U10 HD063020; U10 HD063046; U10 HD063048; and U10 HD063053. In addition, support was provided by Clinical and Translational Science Institutes: UL1TR001108 and UL1TR000153 with supplemental support to NHLBI U10-HL119991 from the Office of Research on Women’s Health and the Office of Disease Prevention. Cooperative agreement funding from the National Heart, Lung, and Blood Institute and the Eunice Kennedy Shriver National Institute of Child Health and Human Development: U10-HL119991; U10-HL119989; U10-HL120034; U10-HL119990; U10-HL120006; U10-HL119992; U10-HL120019; U10-HL119993; U10-HL120018, and U01HL145358; and the National Center for Advancing Translational Sciences through UL-1-TR000124, UL-1-TR000153, UL-1-TR000439, and UL-1-TR001108; and the Barbra Streisand Women’s Cardiovascular Research and Education Program, and the Erika J. Glazer Women’s Heart Research Initiative, Cedars-Sinai Medical Center, Los Angeles with supplemental support to U10-HL119991 from the Office of Research on Women’s Health and the Office of Disease Prevention. This research was additionally supported by R01 HL158652. Dr. Noel Bairey Merz has board service and stock in iRhythm and consulting for SHL Telemedicine. All other authors have no financial disclosures.