Association Between Diastasis of the Rectus Abdominis Muscles and Musculoskeletal Conditions in the First 2 Years Postpartum: A Cross-Sectional Study

Abstract

Objective To explore associations between the presence and severity of diastasis of the rectus abdominis muscles (DRAM) and common postpartum musculoskeletal complaints in the first 2 years postpartum.

Study Design Cross-sectional survey among women within 2 years of childbirth.

Background DRAM commonly affects women during pregnancy and postpartum, but its relationship with musculoskeletal complaints remains unclear. This study investigates the association between DRAM and postpartum musculoskeletal complaints, including low back pain, pelvic girdle pain, abdominal pain, and pelvic floor dysfunction.

Methods and Measures Participants were identified from medical records of women who had delivered a baby in the previous 2 years at Southwest Healthcare, Warrnambool, Victoria, Australia. An electronic questionnaire collected data on DRAM presence and severity (self-reported based on self-assessment or prior healthcare professional screening), musculoskeletal complaints, and pelvic floor dysfunction both currently (within the past week) and early postpartum (within the first 3 months). Statistical univariate and multivariate regression analyses explored associations between DRAM presence or severity and reported symptoms adjusted for age, parity, delivery method and time since last delivery.

Results Of 177 respondents (from 785 survey invitations), 38% (n = 70) reported DRAM. In multivariate analysis, DRAM presence was significantly associated with current (p = 0.034) and early postpartum (p = 0.037) abdominal discomfort, and urinary urgency symptoms early postpartum (p = 0.033). No significant associations were found between DRAM and low back pain, pelvic girdle pain, or stress urinary incontinence.

Conclusion DRAM was weakly associated with abdominal discomfort and urinary urgency symptoms but not with other musculoskeletal complaints. These findings align with limited previous research on this topic. More data are needed to explore the association between DRAM severity and musculoskeletal disorders.