Sedentary Behavior, Physical Activity, and Sleep During Pregnancy and Offspring Health: Protocol for the Pregnancy...

Childhood obesity is a major public health concern that increases cardiovascular disease (CVD) risk. The Developmental Origins of Health and Disease theory posits that obesity and CVD risk is, in part, programmed in utero. A greater understanding of modifiable maternal factors that associate with offspring obesity and CVD risk in childhood could inform primordial prevention interventions during pregnancy. Maternal sedentary behavior, physical activity, and sleep during pregnancy are modifiable and plausible determinants of offspring obesity and CVD risk yet remain insufficiently studied. This protocol describes the design of the Pregnancy 24/7 Offspring Study (NCT07172880), developed to address this gap in knowledge.

This study examines associations between device-based maternal 24-hour movement behavior (sedentary behavior, physical activity, and sleep) measured in each pregnancy trimester and analyzed via trajectories and as compositions with offspring obesity and CVD risk through 24 months of age. Maternal 24-hour movement behavior data and birth outcomes were previously collected in the Pregnancy 24/7 Cohort Study (N=500, Iowa, Pennsylvania, and West Virginia). The Offspring study extends this cohort by enrolling up to 450 maternal-offspring dyads and collecting new measures in the offspring, including body mass index z-score from birth through 24 months obtained via medical record abstraction, anthropometry, indicators of CVD risk, and maternal questionnaires. The primary outcome is body mass index z-score trajectory; secondary outcomes include adiposity, blood pressure, and brachial-femoral pulse wave velocity.

Findings from this study will advance understanding of how maternal 24-hour activity associates with early-life obesity and CVD risk, informing primordial prevention strategies during pregnancy.