Physical Activity During Pregnancy And Postpartum Blood Pressure

BACKGROUND: Pregnancy acts as a natural stress test and may unmask the risk for future cardiovascular disease (CVD). High levels of physical activity (PA) may help mitigate this risk. Examining PA patterns during pregnancy in relation to postpartum blood pressure (BP) may further our understanding of cardiovascular health in the perinatal period. PURPOSE: Investigate associations of steps, light- (LPA), and moderate-to-vigorous-intensity PA (MVPA) in each trimester of pregnancy with postpartum BP. METHODS: Pregnant persons <13 weeks were recruited for the multi-site Pregnancy 24/7 Study. PA was measured each trimester with the activPAL3 micro for 7 days. BP was abstracted from medical records from the first prenatal (11.0 ± 0.9 GA wks) and postpartum visits (5.3 ± 8.4 weeks from delivery). BP was treated as a continuous and categorical variable, with systolic and diastolic examined separately and hypertension defined as ≥130/80 mmHg. Linear and logistic regressions estimated associations of pregnancy PA and postpartum BP. RESULTS: Participants’ (N = 211) PA changed significantly across trimesters; data presented as median (IQR). Steps and LPA were greatest in the 2nd trimester: 7114.7(5138.7-8575.7) steps/day and 255.1(203.9-308.4) min/day. MVPA was greatest in the 1st trimester: 16.4 (4.8-10.8) min/day. More postpartum v. pregnancy BPs were hypertensive (30% v. 11%). Each 1000 additional steps in the 1st trimester was associated with lower postpartum SBP (-0.48 mmHG, p = 0.03, see Table). No other associations were significant. CONCLUSION: BP was significantly higher postpartum, with inverse associations with 1st trimester steps. Future work should examine causes for increases in postpartum BP and effective mitigation strategies. Associations between steps, light-intensity physical activity, and moderate-to-vigorous intensity physical activity each trimester with postpartum blood pressure (N = 211) - Postpartum SBP Postpartum DBP Standardized Estimate P-value Standardized Estimate P-value Trimester 1 Steps -0.48 0.03 -0.03 0.87 Light Physical Activity -0.66 0.17 -0.40 0.33 Moderate to Vigorous Physical Activity -0.56 0.17 -0.13 0.71 Trimester 2 Steps -0.39 0.10 -0.09 0.63 Light Physical Activity -0.55 0.26 0.03 0.93 Moderate to Vigorous Physical Activity -0.61 0.17 -0.30 0.43 Trimester 3 Steps -0.23 0.46 0.24 0.35 Light Physical Activity -0.48 0.34 0.56 0.20 Moderate to Vigorous Physical Activity -0.45 0.47 0.05 0.92 R01 HL153095 (PI Dr. Kara Whitaker)