Abstract
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. 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). 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. 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.
Published Version
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