Diastasis recti abdominis during pregnancy and 12 months after childbirth: prevalence, risk factors and report of lumbopelvic pain

Sperstad JB; Tennfjord MK; Hilde G; Ellström-Engh M; Bø K

doi:10.1136/bjsports-2016-096065

Postpartum · Recovery

Diastasis recti abdominis during pregnancy and 12 months after childbirth: prevalence, risk factors and report of lumbopelvic pain

Sperstad JB, Tennfjord MK, Hilde G, Ellström-Engh M, Bø K

Published September 2016 British journal of sports medicine

DOI 10.1136/bjsports-2016-096065 PMID 27324871 PMC PMC5013086

RRM Academy Synopsis

Diastasis recti affected 60% of Norwegian first-time mothers at 6 weeks

In a Norwegian prospective cohort of 300 first-time mothers, diastasis recti affected about 6 out of 10 women 6 weeks after birth. Of 178 women examined a year after birth, about 3 out of 10 had it, mostly mild. At 12 months, lumbopelvic pain was not significantly different with or without diastasis recti.

About 6 in 10 first-time mothers had diastasis recti 6 weeks after birth. Source: Sperstad JB et al., 2016, PMID 27324871.

Study at a glance, prospective cohort: Diastasis recti affected 60% of Norwegian first-time mothers at 6 weeks — Study at a glance, prospective cohort of 300 first-time mothers: Diastasis recti affected 60% of Norwegian first-time mothers at 6 weeks. Source: Sperstad JB et al., 2016, PMID 27324871.

Key Findings

In 300 first-time mothers, prevalence of diastasis recti abdominis was 33.1% at pregnancy week 21, 60.0% at 6 weeks after birth and 32.6% at 12 months.
At 6 weeks, 154 of 285 women (54%) had mild separation, 16 (5.6%) moderate and 1 (0.4%) severe; at 12 months, 2 women had moderate and none severe.
Women who reported heavy lifting 20 or more times a week had higher odds of diastasis recti at 12 months (OR 2.18, 95% CI 1.05 to 4.52).
Age, weight before pregnancy, weight gain in pregnancy, cesarean section and baby's birth weight did not differ significantly between women with and without diastasis recti at 12 months.
At 12 months, 45.6% of women with diastasis recti and 32.5% of those without reported lumbopelvic pain (low back or pelvic girdle pain); the authors report no difference (p=0.10).

Interpretation

The study was a prospective cohort. Researchers followed one group of women forward in time from week 21 of pregnancy, examining 299 women at week 21 and 178 at 12 months after birth. The 300 women were first-time mothers with single pregnancies, and 96% were of European ethnicity. Two physiotherapists measured the separation of the abdominal muscles by palpation, and questionnaires supplied the pain and lifting data. The authors note that the lifting result has a wide confidence interval and that many variables were tested, so the result should be read with caution. They call for more research on prevention and treatment programs.

RRM Context

Restorative reproductive medicine (RRM) sees a woman's health as a whole, across her body and her life. Recovery after childbirth is part of that. RRM puts evaluation before treatment and asks what a finding means first. The authors cite a systematic review that found no high-quality randomized trials of abdominal training programs for diastasis recti.

Our editorial summary of this paper, not the article's abstract.

Abstract

Background and Aims

Diastasis recti abdominis (DRA) is defined as a separation of the 2 muscle bellies of rectus abdominis. To date there is scant knowledge on prevalence, risk factors, and consequences of the condition. The present study aimed to investigate the prevalence of DRA during pregnancy and post partum, presence of possible risk factors, and the occurrence of lumbopelvic pain among women with and without DRA.

Methods

This prospective cohort study followed 300 first-time pregnant women from pregnancy till 12 months post partum. Data were collected by electronic questionnaire and clinical examinations. DRA was defined as a palpated separation of ≥2 fingerbreadths either 4.5 cm above, at or 4.5 cm below the umbilicus. Women with and without DRA were compared with independent samples Student's t-test and χ(2)/Fisher exact test, and OR with significance level >0.05.

Results

Prevalence of DRA was 33.1%, 60.0%, 45.4%, and 32.6% at gestation week 21, 6 weeks, 6 months and 12 months post partum, respectively. No difference in risk factors was found when comparing women with and without DRA. OR showed a greater likelihood for DRA among women reporting heavy lifting ≥20 times weekly (OR 2.18 95% CI 1.05 to 4.52). There was no difference in reported lumbopelvic pain (p=0.10) in women with and without DRA.

Conclusions

Prevalence of mild DRA was high both during pregnancy and after childbirth. Women with and without DRA reported the same amount of lumbopelvic pain 12 months post partum.

Topics

Postpartum Recovery Physical Recovery

Postpartum › Recovery › Physical Recovery

Jorun Bakken Sperstad, Merete Kolberg Tennfjord, Gunvor Hilde, Marie Ellström-Engh, Kari Bø

J Sperstad, M Tennfjord, G Hilde, M Ellström-Engh, K Bø

PMID 27324871 27324871 DOI 10.1136/bjsports-2016-096065 10.1136/bjsports-2016-096065 Sperstad et al. 2016, Sperstad 2016

Diastasis recti abdominis during pregnancy and 12 months after childbirth: prevalence, risk factors and report of lumbopelvic pain

Diastasis recti affected 60% of Norwegian first-time mothers at 6 weeks

Key Findings

Interpretation

RRM Context

Abstract

Topics

By this author

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