Top Things to Know: Sedentary Behavior and Light-Intensity Physical Activity During Pregnancy and Cardiovascular Health
Published: April 10, 2025
Prepared by Kara M. Whitaker, PhD, MPH, Health and Human Physiology, University of Iowa
- The benefits of moderate-to-vigorous intensity physical activity during pregnancy on maternal cardiovascular health (CVH) are well established and include reduced risk of excessive gestational weight gain, gestational diabetes, and hypertensive disorders of pregnancy.
- Growing evidence suggests a behavior profile with less sedentary behavior and more light-intensity physical activity is associated with more favorable cardiovascular health in the general adult population.
- Little is known about how sedentary behavior and light-intensity physical activity relate to cardiovascular health during pregnancy.
- Given that lower-intensity behaviors are an evolving scientific issue of high interest to the public and health professionals, it is important to understand how these behaviors relate to cardiovascular health during the critical life transition of pregnancy.
- This advisory highlights evidence on device-measured sedentary behavior and light-intensity physical activity related to CVH during pregnancy, focusing on adverse pregnancy outcomes and the American Heart Association’s Life’s Essential 8 components (blood pressure, lipids, glucose, and gestational weight gain).
- Observational evidence from 14 studies was mixed; however, preliminary findings from two cross-sectional and nine cohort studies demonstrated an association of high sedentary behavior with increased risk of hypertensive disorders of pregnancy, shorter gestational age at delivery, low or high birth weight, and elevated maternal blood pressure, lipids, glucose, and gestational weight gain.
- Experimental evidence on reducing sedentary behavior or increasing light physical activity during pregnancy is limited, with only three small studies. However, two randomized controlled trials suggest that such interventions could be beneficial.
- Future observational studies with rigorous longitudinal designs and larger sample sizes are needed to confirm associations and inform the design of well-powered randomized-controlled trials testing the efficacy of decreasing sedentary behavior and increasing light-intensity physical activity on pregnancy cardiovascular health.
- Future methodological needs include clarifying associations of 24-hour movement behaviors (sedentary behavior, physical activity, and sleep) with cardiovascular health during pregnancy.
- Additional research is essential to confirm these preliminary findings demonstrating adverse associations of high sedentary behavior and cardiovascular risk in pregnancy to inform lifestyle interventions and guidelines.
Citation
Whitaker KM, Barone Gibbs B, Hivert M-F, Makarem N, Moxley E, Vaught J, Evenson KR; on behalf of the American Heart Association Council on Lifestyle and Cardiometabolic Health; Council on Cardiovascular and Stroke Nursing; and Council on Cardiovascular Surgery and Anesthesia. Sedentary behavior and light-intensity physical activity during pregnancy and cardiovascular health: a science advisory from the American Heart Association. Circulation. Published online April 10, 2025. doi: 10.1161/CIR.0000000000001316