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

Abstract

Purpose: 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. Methods: 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 (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 yr 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 after pregnancy, including among those who experienced HDP or GDM.