{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T05:04:33Z","timestamp":1789535073129,"version":"build-2803163510"},"reference-count":42,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"18","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,9,15]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">How prepregnancy body mass index (BMI) and pregnancy physical activity (PA) jointly shape postpartum cardiovascular risk remains unclear. This study evaluated whether joint trajectories of PA and sedentary behavior during pregnancy mediate the association between prepregnancy BMI and postpartum blood pressure (BP).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">Pregnancy 24\/7 is a multisite observational cohort enrolling individuals &lt;13\u2009weeks' gestation, aged 18 to 45\u2009years, without chronic hypertension, diabetes, sleep disorders, or severe mobility limitation (n=500). Participants with valid PA\/sedentary behavior data for \u22651 trimester and a clinic BP reading 4 to 8\u2009weeks postpartum were analyzed. Prepregnancy BMI was chart\u2010abstracted; PA\/sedentary behavior were measured each trimester via the activPAL3 micro. Hypertensive postpartum BP was defined as systolic BP \u2265130\u2009mm\u2009Hg or diastolic BP \u226580\u2009mm\u2009Hg. Parallel\u2010process latent growth modeling and K\u2010means clustering identified PA trajectory groups; mediation analysis tested whether these groups explained the BMI\u2010BP association.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">Among 388 participants (aged 30.9\u00b14.5\u2009years), 109 (28.4%) had hypertensive postpartum BP. Each 1\u2010unit increase in prepregnancy BMI was associated with 6.0% greater risk of hypertensive postpartum BP (risk ratio, 1.06 [95% CI, 1.04\u20131.09]), adjusting for demographic and pregnancy characteristics. Three trajectory groups emerged: active\u2010declining (n=142), active\u2010improving (n=103), and consistently sedentary (n=143). The active\u2010declining group had 37% lower risk than the consistently sedentary group, but this attenuated after BMI adjustment. Physical activity trajectories did not mediate the BMI\u2010BP relationship, which was largely explained by prepregnancy BMI alone.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Prepregnancy BMI predicted hypertensive postpartum BP independent of activity patterns, underscoring the clinical value of prepregnancy weight optimization and vigilant postpartum monitoring for those entering pregnancy with elevated BMI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Registration<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      URL:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n                      ; Unique identifier: NCT04749849.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.126.051063","type":"journal-article","created":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T14:47:41Z","timestamp":1788965261000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Prepregnancy Body Mass Index, Pregnancy Physical Activity Trajectories, and Postpartum Blood Pressure"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3351-0173","authenticated-orcid":false,"given":"Jaclyn D.","family":"Borrowman","sequence":"first","affiliation":[{"name":"Northwestern University","place":["Chicago, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex H.","family":"Crisp","sequence":"additional","affiliation":[{"name":"Sport, and Human Physiology, University of Iowa","place":["Iowa City, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7919-5247","authenticated-orcid":false,"given":"Melissa A.","family":"Jones","sequence":"additional","affiliation":[{"name":"Oakland University","place":["Rochester, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9551-851X","authenticated-orcid":false,"given":"Janet M.","family":"Catov","sequence":"additional","affiliation":[{"name":"Gynecology, and Reproductive Science, University of Pittsburgh","place":["Pittsburgh, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0732-6148","authenticated-orcid":false,"given":"Bethany Barone","family":"Gibbs","sequence":"additional","affiliation":[{"name":"West Virginia University","place":["Morgantown, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2343-4162","authenticated-orcid":false,"given":"Kara M.","family":"Whitaker","sequence":"additional","affiliation":[{"name":"Sport, and Human Physiology, University of Iowa","place":["Iowa City, USA"]},{"name":"College of Public Health, University of Iowa","place":["Iowa City, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000442009.06663.48"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0038-1669441"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.xagr.2025.100519"},{"key":"e_1_3_1_5_2","unstructured":"Obesity among women of childbearing age: United States 2012\u20132023. 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