| Summary: | <i>Background and Objectives:</i> There is lack of knowledge on whether mothers’ gestational diabetes (GDM) risk is related to their physical activity (PA) or their children’s PA and body composition. We aimed to examine the difference in (1) change in self-reported PA from pre-pregnancy to seven-year follow-up and (2) accelerometer-based PA at seven years after delivery between the mothers having GDM risk (GDMRyes-mothers) and not having GDM risk (GDMRno-mothers). Furthermore, we examined the difference in children’s PA and/or body composition at six years of age according to their mothers’ GDM risk. <i>Materials and Methods:</i> The study included 199 Finnish women. GDM risk factors were screened at the beginning of pregnancy, and the women were classified as GDMRyes-mothers if they had at least one GDM risk factor (body mass index ≥25 kg/m<sup>2</sup>; age ≥40 years; family history of diabetes; GDM, signs of glucose intolerance, or newborn’s macrosomia (≥4500 g) in earlier pregnancy) or as GDMRno-mothers if they had no risk factors. Mothers’ PA was assessed by self-reporting at 8−12 gestational weeks concerning pre-pregnancy PA and at a follow-up seven years after the delivery. Moreover, mothers’ and their children’s PA was measured using a triaxial Hookie AM20-accelerometer at seven years after delivery. Children’s body composition was assessed using a TANITA bioelectrical impedance device. Adjusted linear regression analyses were applied. <i>Results:</i> GDMRno-mothers increased their self-reported PA more than GDMRyes-mothers from pre-pregnancy to the seven-year follow-up. Concerning women’s measured PA as well as children’s PA and body composition at seven years after delivery, the differences were non-significant between GDMRyes-mothers and GDMRno-mothers. However, of the GDM risk factors, mothers’ pre-pregnancy body mass index was positively related to unhealthier body composition in boys at six years of age. <i>Conclusion:</i> Health promotion should be targeted at women with GDM risk factors, in particular overweight women, in enhancing women’s PA in the long term and their children’s healthy body composition.
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