Journal article
Optimal 24-hour movement behaviour compositions across trimesters and risk of hypertensive disorders of pregnancy: the Pregnancy 24/7 cohort study
British journal of sports medicine
06/10/2026
DOI: 10.1136/bjsports-2025-111091
PMID: 42270313
Abstract
ObjectivesHypertensive disorders of pregnancy (HDP) are primary antecedents of maternal cardiovascular morbidity during and after pregnancy. Despite evidence that 24-hour movement behaviours, including moderate-to-vigorous and light-intensity physical activity (MVPA, LPA), sedentary behaviour (SED) and sleep, relate to cardiovascular disease risk, associations with HDP are unknown. This study identified optimal 24-hour behavioural compositions across pregnancy associated with lower HDP risk.MethodsThe Pregnancy 24/7 cohort study (N=500) quantified 24-hour movement behaviours in each trimester (100–126, 200–226 and 320–346 weeks gestation) and examined associations with HDP. Participants were enrolled between 2021–2024 from three US study sites. Movement behaviours were quantified from 7-day × 24-hour monitor wear using the activPAL3 micro (MVPA, LPA and SED) and Actiwatch Spectrum Plus (sleep). HDP (gestational hypertension and pre-eclampsia) was abstracted from medical records. Compositional binomial regression models predicted HDP risk based on isometric log-ratio transformation of 24-hour movement behaviours. Optimal overlapping behavioural compositions were identified by aggregating up to three repeated assessments of 24-hour data.ResultsAmong 470 participants with complete data, 86 (18.3%) developed HDP. The optimal overlapping daily composition (0–5th percentile) associated with the lowest HDP risk (7.2%) consisted of 5.9 (5.5–6.6) hours SED, 7.9 (6.4–8.9) hours LPA, 7 (2–22) minutes MVPA and 10.1 (8.5–11.3) hours sleep. Risk increased exponentially among participants with more than 10 hours/day of SED or less than 5 hours/day of LPA.ConclusionSED and LPA were the strongest modifiable predictors of HDP, independent of trimester. These findings inform behavioural intervention targets to reduce the risk of HDP.
Details
- Title: Subtitle
- Optimal 24-hour movement behaviour compositions across trimesters and risk of hypertensive disorders of pregnancy: the Pregnancy 24/7 cohort study
- Creators
- Kara Whitaker - University of IowaAlex Crisp - University of IowaJacob Gallagher - Iowa State UniversityMelissa Jones - Oakland UniversityJaemyung Kim - University of IowaKatrina Wilhite - West Virginia UniversityKarina Smith - University of IowaSabera Rahman - University of PittsburghAlexis Thrower - West Virginia UniversityJanet Catov - University of PittsburghChristopher Kline - University of PittsburghMaisa Feghali - University of PittsburghDonna Santillan - University of IowaMark Santillan - University of IowaIqra Sheikh - West Virginia UniversityBridget Zimmerman - University of Iowa, BiostatisticsBethany Barone Gibbs - West Virginia University
- Resource Type
- Journal article
- Publication Details
- British journal of sports medicine
- DOI
- 10.1136/bjsports-2025-111091
- PMID
- 42270313
- NLM abbreviation
- Br J Sports Med
- ISSN
- 0306-3674
- eISSN
- 1473-0480
- Publisher
- BMJ Publishing Group Ltd and British Association of Sport and Exercise Medicine
- Grant note
- U54GM104942 / West Virginia Clinical and Translational Science Institute UL1TR001857 / University of Pittsburgh Clinical and Translational Science Institute R01HL153095 / National Heart, Lung, and Blood Institute (http://dx.doi.org/10.13039/100000050) UL1TR002537 / University of Iowa Institute for Clinical and Translational Science
- Language
- English
- Electronic publication date
- 06/10/2026
- Academic Unit
- Epidemiology; Biostatistics; Obstetrics and Gynecology; Health, Sport, and Human Physiology
- Record Identifier
- 9985172993202771
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