Abstract
Recent studies have suggested that adverse outcomes of postterm birth (≥42 completed weeks of gestation), including increased cardiometabolic risk factors, impaired glucose metabolism, and obesity, may extend into adulthood. We studied interconnected determinants of cardiovascular health, including physical activity (PA; based on accelerometry for 2 weeks), muscular strength (measured by handgrip strength), cardiorespiratory fitness (CRF; measured by 4-min step test), and cardiac autonomic function (heart rate [HR] recovery, HR variability, and baroreflex sensitivity) among 46-year-old adults from the Northern Finland Birth Cohort born postterm (n = 805) and at term (n = 2645). Adults born postterm undertook vigorous PA 2.0 min day-1 (95% CI, 0.4-3.7) less than term-born adults when adjusted for sex, age, and maternal- and pregnancy-related covariates in multiple linear regression. Postterm birth was associated with reduced CRF, based on a higher peak HR (2.1 bpm; 95% CI, 0.9-3.4) and slower HR recovery 30 s after the step test (-0.7 bpm; 95% CI, -1.3 to -0.1). Postterm birth was associated with less PA of vigorous intensity and CRF and slower HR recovery in middle age. Our findings reinforce previous suggestions that postterm birth should be included as a perinatal risk factor for adult cardiometabolic disease.