Gestational Weight Gain, Postpartum Weight Retention, and Women's Mid‐Life Cardiovascular Health in Project Viva

ABSTRACT Objective This study aimed to examine associations of gestational weight gain (GWG) and postpartum weight retention (PPWR) with women's mid‐life cardiovascular health. Methods We studied 838 Project Viva participants enrolled 1999–2002 (mean age: 32.6 years). We categorized GWG as inadequate, adequate, or excessive using 2009 Institute of Medicine guidelines and calculated PPWR at 6 months, 1 year, and 2 years. At the Mid‐Life Visit (2017–2021; mean age: 51.0 years), we derived Life's Essential 8 (LE8) scores (0–100; higher = better). We used linear regression models adjusted for pre‐pregnancy BMI, age at enrollment, pregnancy smoking status, household income, and educational attainment. Results Excessive versus adequate GWG was associated with worse weight status ( β = −8.99, 95% CI: −12.81, −5.18) but not with the overall LE8 score ( β = −1.93, 95% CI: −3.92, 0.07) or the biomedical domain score ( β = −2.31, 95% CI: −5.66, 1.05). Each 1‐kg higher 1‐year PPWR was associated with worse biomedical domain ( β = −0.49, 95% CI: −0.84, −0.14), weight status ( β = −1.54, 95% CI: −1.90, −1.17), and blood pressure scores ( β = −0.62, 95% CI: −1.15, −0.10). PPWR at 6 months and 2 years was also associated with worse glycemic traits scores. Conclusions Excessive GWG was associated primarily with worse mid‐life weight status, whereas higher PPWR was associated with worse mid‐life cardiovascular health.