# Risk factors of diastasis recti abdominis, and relationship with surface electromyography characteristics of pelvic floor muscles in early postpartum: a retrospective study

## TL;DR

This study found that older age, lower education, and more births are linked to a higher risk of diastasis recti abdominis after childbirth, but no connection was found with pelvic floor muscle activity.

## Contribution

The study identifies novel risk factors for diastasis recti abdominis and clarifies the lack of relationship with pelvic floor muscle activity in early postpartum women.

## Key findings

- Older maternal age, lower education level, and higher parity are independently associated with increased DRA risk.
- No significant differences in sEMG parameters were found between DRA and non-DRA groups.
- Pre- and postpartum BMI were higher in the DRA group compared to the non-DRA group.

## Abstract

This study aimed to identify the factors associated with diastasis recti abdominis (DRA) in early postpartum women and investigate any relationship with surface electromyography (sEMG) characteristics of pelvic floor muscles (PFM).

A total of 478 participants who visited Fujian Maternity and Child Health Hospital for postpartum re-examination between January and March 2023 were divided into two groups: DRA and Non-DRA. Basic demographic data were collected via self-reported questionnaires. Additionally, inter-recti distance (IRD) was measured using ultrasound imaging, and pelvic floor muscle activity was assessed using surface electromyography according to the Glazer protocols.

There were no significant differences between the non-DRA and DRA groups in terms of weight gain during pregnancy, physical activity, number of fetuses, delivery mode, gestational diabetes, or urinary incontinence during pregnancy or postpartum. However, the DRA group was older and had a significantly lower level of education. Both pre-pregnancy and postpartum body mass index (BMI) were higher in the DRA group. The proportion of first-time mothers was greater in the non-DRA group, and fetal weight was lower in the non-DRA group compared to the DRA group. Multivariate logistic regression analysis revealed that older maternal age, lower education level, and a high number of deliveries were independently associated with an increased risk of DRA. No significant differences were observed in sEMG parameters between the two groups at the pre-baseline, flick contraction, tonic contraction, endurance contraction, and post-baseline stages.

Older maternal age, lower educational attainment, and higher parity were significantly associated with an increased risk of diastasis recti abdominis in early postpartum. No correlation was found between the sEMG characteristics of pelvic floor muscles and diastasis recti abdominis in the early postpartum period.