{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,9]],"date-time":"2026-11-09T22:45:20Z","timestamp":1794264320403,"version":"4.9.0"},"reference-count":32,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,2,15]],"date-time":"2021-02-15T00:00:00Z","timestamp":1613347200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2021,2,15]],"date-time":"2021-02-15T00:00:00Z","timestamp":1613347200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Women's Health"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Diastasis of rectus abdominis (DRA) refers to a separation of the rectus abdominis from the linea alba. This study aimed to investigate the association with the severity of DRA for developing pelvic floor dysfunction among women during the first year postpartum.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This is a retrospective cohort study which collected data from 229 postpartum women. DRA was defined as a separation of\u2009\u2265\u200920\u00a0mm at any point 4.5\u00a0cm above, at and 4.5\u00a0cm below the umbilicus. The data for analysis includes pelvic organ prolapse quantification (POP-Q), medical history of urinary incontinence (UI), the strength of rectus abdominis muscle and pelvic floor muscle. The differences in women with and without DRA were compared with independent samples t-test and Chi-square test.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Prevalence of DRA was 82.6% during the first postpartum year. Cesarean section and multiple parturitions are recognized as risk factors for DRA due to the odds ratio in our study were 3.48 (95% CI 1.42\u20138.56), 3.20 (95% CI 1.59\u20136.45) respectively. There was no difference in the occurrence of UI and pelvic organ prolapse (POP) comparing women with and without DRA, even changing the cut-off values (inter-rectus distance\u2009=\u200920\u00a0mm, 30\u00a0mm, 40\u00a0mm, 50\u00a0mm) for determining DRA. The women with weak rectus abdominis muscle and pelvic floor muscle have no statistical difference in two group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The relationship of the diastasis recti abdominis and pelvic floor dysfunction has no connection, even with the severity of inter-rectus distance increasing.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12905-021-01194-8","type":"journal-article","created":{"date-parts":[[2021,2,17]],"date-time":"2021-02-17T09:23:12Z","timestamp":1613553792000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":40,"title":["The relationship of severity in diastasis recti abdominis and pelvic floor dysfunction: a retrospective cohort study"],"prefix":"10.1186","volume":"21","author":[{"given":"Hui","family":"Fei","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yun","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mengxiong","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan","family":"He","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lixiang","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juanhua","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Wan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9036-4585","authenticated-orcid":false,"given":"Tian","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,2,15]]},"reference":[{"issue":"7","key":"1194_CR1","doi-asserted-by":"publisher","first-page":"1082","DOI":"10.1093\/ptj\/68.7.1082","volume":"68","author":"BJ Schiff","year":"1988","unstructured":"Schiff BJ, Jo BM. Incidence of diastasis recti abdominis during the childbearing year. Phys Ther. 1988;68(7):1082\u20136.","journal-title":"Phys Ther"},{"key":"1194_CR2","first-page":"49","volume":"97","author":"G Candido","year":"2005","unstructured":"Candido G, Lo T, Janssen P. Risk factors for diastasis of the recti abdominis. J Assoc Chartered Physiother Womens Health. 2005;97:49\u201354.","journal-title":"J Assoc Chartered Physiother Womens Health"},{"issue":"1","key":"1194_CR3","doi-asserted-by":"publisher","first-page":"200","DOI":"10.1016\/j.math.2014.09.002","volume":"20","author":"PG Fernandes da Mota","year":"2015","unstructured":"Fernandes da Mota PG, et al. Prevalence and risk factors of diastasis recti abdominis from late pregnancy to 6 months postpartum, and relationship with lumbo-pelvic pain. Manual Therapy. 2015;20(1):200\u20135.","journal-title":"Manual Therapy"},{"issue":"4","key":"1194_CR4","doi-asserted-by":"publisher","first-page":"260","DOI":"10.1093\/ptj\/pzy008","volume":"98","author":"SL Gluppe","year":"2018","unstructured":"Gluppe SL, et al. Effect of a postpartum training program on prevalence of diastasis recti abdominis in postpartum primiparous women: a randomized controlled trial. Phys Ther. 2018;98(4):260\u20138.","journal-title":"Phys Ther"},{"issue":"11","key":"1194_CR5","first-page":"817","volume":"82","author":"T Volkan","year":"2011","unstructured":"Volkan T, et al. Prevalence of diastasis recti abdominis in the population of young multiparous adults in Turkey. Ginekol Pol. 2011;82(11):817\u201321.","journal-title":"Ginekol Pol"},{"issue":"1","key":"1194_CR6","doi-asserted-by":"publisher","first-page":"277","DOI":"10.1007\/s00192-019-04005-9","volume":"31","author":"Q Wang","year":"2020","unstructured":"Wang Q, et al. Does diastasis recti abdominis weaken pelvic floor function? A cross-sectional study. Int Urogynecol J. 2020;31(2):277\u201383.","journal-title":"Int Urogynecol J"},{"issue":"2","key":"1194_CR7","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1097\/01274882-200933020-00003","volume":"33","author":"MA Parker","year":"2009","unstructured":"Parker MA, et al. Diastasis rectus abdominis and lumbo-pelvic pain and dysfunction-are they related? J Women Health Phys Therapy. 2009;33(2):15\u201322.","journal-title":"J Women Health Phys Therapy"},{"issue":"4","key":"1194_CR8","doi-asserted-by":"publisher","first-page":"275","DOI":"10.1590\/S1413-35552009005000037","volume":"13","author":"MT Rett","year":"2009","unstructured":"Rett MT, et al. Prevalence of diastasis of the rectus abdominis muscles immediately postpartum: comparison between primiparae and multiparae. Revista Brasileira de Fisioterapia. 2009;13(4):275\u201380.","journal-title":"Revista Brasileira de Fisioterapia"},{"issue":"3","key":"1194_CR9","doi-asserted-by":"publisher","first-page":"321","DOI":"10.1007\/s00192-006-0143-5","volume":"18","author":"TM Spitznagle","year":"2007","unstructured":"Spitznagle TM, Leong FC, Van Dillen LR. Prevalence of diastasis recti abdominis in a urogynecological patient population. Int Urogynecol J Pelvic Floor Dysfunct. 2007;18(3):321\u20138.","journal-title":"Int Urogynecol J Pelvic Floor Dysfunct"},{"issue":"2","key":"1194_CR10","doi-asserted-by":"publisher","first-page":"191","DOI":"10.1007\/s00192-016-3123-4","volume":"28","author":"K B\u00f8","year":"2017","unstructured":"B\u00f8 K, Frawley HC, Haylen BT, Abramov Y, Almeida FG, Berghmans B, Bortolini M, Dumoulin C, Gomes M, McClurg D, Meijlink J, Shelly E, Trabuco E, Walker C, Wells A. An International Urogynecological Association (IUGA)\/International Continence Society (ICS) joint report on the terminology for the conservative and nonpharmacological management of female pelvic floor dysfunction. Int Urogynecol J. 2017;28(2):191\u2013213. https:\/\/doi.org\/10.1007\/s00192-016-3123-4.","journal-title":"Int Urogynecol J."},{"issue":"9566","key":"1194_CR11","doi-asserted-by":"publisher","first-page":"1027","DOI":"10.1016\/S0140-6736(07)60462-0","volume":"369","author":"JE Jelovsek","year":"2007","unstructured":"Jelovsek JE, Maher C, Barber MD. Pelvic organ prolapse. Lancet. 2007;369(9566):1027\u201338.","journal-title":"Lancet"},{"issue":"11","key":"1194_CR12","doi-asserted-by":"publisher","first-page":"1559","DOI":"10.1007\/s00192-015-2695-8","volume":"26","author":"TF Vergeldt","year":"2015","unstructured":"Vergeldt TF, et al. Risk factors for pelvic organ prolapse and its recurrence: a systematic review. Int Urogynecol J. 2015;26(11):1559\u201373.","journal-title":"Int Urogynecol J"},{"issue":"2 Pt 1","key":"1194_CR13","doi-asserted-by":"publisher","first-page":"324","DOI":"10.1097\/01.AOG.0000267220.48987.17","volume":"111","author":"VA Minassian","year":"2008","unstructured":"Minassian VA, Stewart WF, Wood GC. Urinary incontinence in women\u2014variation in prevalence estimates and risk factors. Obstet Gynecol. 2008;111(2 Pt 1):324\u201331.","journal-title":"Obstet Gynecol"},{"issue":"5","key":"1194_CR14","doi-asserted-by":"publisher","first-page":"363","DOI":"10.1007\/s11934-011-0215-z","volume":"12","author":"L Stothers","year":"2011","unstructured":"Stothers L, Friedman B. Risk factors for the development of stress urinary incontinence in women. Curr Urol Rep. 2011;12(5):363\u20139.","journal-title":"Curr Urol Rep"},{"issue":"3","key":"1194_CR15","doi-asserted-by":"publisher","first-page":"716","DOI":"10.1002\/nau.23005","volume":"36","author":"K B\u00f8","year":"2017","unstructured":"B\u00f8 K, et al. Pelvic floor muscle function, pelvic floor dysfunction and diastasis recti abdominis: prospective cohort study. Neurourol Urodyn. 2017;36(3):716\u201321.","journal-title":"Neurourol Urodyn"},{"issue":"17","key":"1194_CR16","doi-asserted-by":"publisher","first-page":"1092","DOI":"10.1136\/bjsports-2016-096065","volume":"50","author":"JB Sperstad","year":"2016","unstructured":"Sperstad JB, et al. Diastasis recti abdominis during pregnancy and 12 months after childbirth: prevalence, risk factors and report of lumbopelvic pain. Br J Sports Med. 2016;50(17):1092\u20136.","journal-title":"Br J Sports Med"},{"issue":"1","key":"1194_CR17","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1002\/1520-6777(2001)20:1<31::AID-NAU5>3.0.CO;2-P","volume":"20","author":"RR Sapsford","year":"2001","unstructured":"Sapsford RR, et al. Co-activation of the abdominal and pelvic floor muscles during voluntary exercises. Neurourol Urodyn. 2001;20(1):31\u201342.","journal-title":"Neurourol Urodyn"},{"issue":"1","key":"1194_CR18","doi-asserted-by":"publisher","first-page":"24","DOI":"10.1016\/j.physio.2018.07.002","volume":"105","author":"DR Benjamin","year":"2018","unstructured":"Benjamin DR, et al. Relationship between diastasis of the rectus abdominis muscle (DRAM) and musculoskeletal dysfunctions, pain and quality of life: a systematic review. Physiotherapy. 2018;105(1):24\u201334.","journal-title":"Physiotherapy"},{"issue":"1","key":"1194_CR19","doi-asserted-by":"publisher","first-page":"200","DOI":"10.1016\/j.math.2014.09.002","volume":"20","author":"PG Fernandes da Mota","year":"2015","unstructured":"Fernandes da Mota PG, et al. Prevalence and risk factors of diastasis recti abdominis from late pregnancy to 6 months postpartum, and relationship with lumbo-pelvic pain. Man Ther. 2015;20(1):200\u20135.","journal-title":"Man Ther"},{"issue":"9","key":"1194_CR20","doi-asserted-by":"publisher","first-page":"656","DOI":"10.2519\/jospt.2019.8543","volume":"49","author":"N Beamish","year":"2019","unstructured":"Beamish N, et al. Differences in Linea Alba stiffness and Linea Alba distortion between women with and without diastasis recti abdominis: the impact of measurement site and task. J Orthop Sports Phys Ther. 2019;49(9):656\u201365.","journal-title":"J Orthop Sports Phys Ther"},{"key":"1194_CR21","unstructured":"Gail Sinquefield MSN, CNM. Essential exercises for the child-bearing year: A guide to health and comfort before and after your baby is born: Second edition, Revised. by Elizabeth Noble. Boston: Houghton Mifflin Company, 1982. 177 p. J Nurse-Midwifery. 2011;28(1):46."},{"issue":"1","key":"1194_CR22","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1097\/01274882-200529010-00003","volume":"29","author":"CM Chiarello","year":"2005","unstructured":"Chiarello CM, et al. The effects of an exercise program on diastasis recti abdominis in pregnant women. J Womens Health Phys Ther. 2005;29(1):11\u20136.","journal-title":"J Womens Health Phys Ther"},{"issue":"6","key":"1194_CR23","doi-asserted-by":"publisher","first-page":"706","DOI":"10.1002\/ca.20836","volume":"22","author":"GM Beer","year":"2009","unstructured":"Beer GM, et al. The normal width of the Linea Alba in nulliparous women. Clin Anat. 2009;22(6):706\u201311.","journal-title":"Clin Anat"},{"issue":"6","key":"1194_CR24","doi-asserted-by":"publisher","first-page":"435","DOI":"10.2519\/jospt.2011.3507","volume":"41","author":"LJ Liaw","year":"2011","unstructured":"Liaw LJ, et al. The relationships between inter-recti distance measured by ultrasound imaging and abdominal muscle function in postpartum women: a 6-month follow-up study. J Orthop Sports Phys Ther. 2011;41(6):435\u201343.","journal-title":"J Orthop Sports Phys Ther"},{"key":"1194_CR25","volume-title":"Daniels and Worthingham\u2019s muscle testing: techniques of manual examination","author":"HJ Hislop","year":"2007","unstructured":"Hislop HJ, Montgomery J. Daniels and Worthingham\u2019s muscle testing: techniques of manual examination. 8th ed. Philadelphia: W.B. Saunders; 2007.","edition":"8"},{"issue":"1","key":"1194_CR26","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1111\/j.1471-0528.1989.tb01570.x","volume":"96","author":"SA Gilpin","year":"1989","unstructured":"Gilpin SA, et al. The pathogenesis of genito-urinary prolapse and stress incontinence of urine: a histological and histochemical study. Br J Obstet Gynaecol. 1989;96(1):15\u201323.","journal-title":"Br J Obstet Gynaecol"},{"issue":"12","key":"1194_CR27","doi-asserted-by":"publisher","first-page":"631","DOI":"10.1016\/S0031-9406(05)61108-X","volume":"87","author":"J Laycock","year":"2001","unstructured":"Laycock J, Jerwood D. Pelvic floor muscle assessment: the PERFECT scheme. Physiotherapy. 2001;87(12):631\u201342.","journal-title":"Physiotherapy"},{"key":"1194_CR28","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-4471-3569-2_5","volume-title":"Pelvic floor re-education","author":"P Norton","year":"1994","unstructured":"Norton P, et al. Pelvic floor re-education. London: Springer; 1994."},{"issue":"10","key":"1194_CR29","first-page":"883","volume":"80","author":"K B\u00f8","year":"2015","unstructured":"B\u00f8 K, Finckenhagen HB. Vaginal palpation of pelvic floor muscle strength: inter-test reproducibility and comparison between palpation and vaginal squeeze pressure. J Urol. 2015;80(10):883\u20137.","journal-title":"J Urol"},{"key":"1194_CR30","first-page":"301","volume-title":"Therapeutic management of incontinence and pelvic pain: pelvic organ disorders,","year":"2007","unstructured":"Laycock J, Haslam J, editors. Therapeutic management of incontinence and pelvic pain: pelvic organ disorders, vol. XXIII. London: Springer; 2007. p. 301."},{"key":"1194_CR31","doi-asserted-by":"publisher","first-page":"808","DOI":"10.2519\/jospt.2015.6143","volume":"45","author":"N Keshwani","year":"2015","unstructured":"Keshwani N, Mathur S, Mclean L. Validity of inter-rectus distance measurement in postpartum women using extended field of view ultrasound imaging techniques. J Orthop Sports Phys Ther. 2015;45:808\u201313.","journal-title":"J Orthop Sports Phys Ther"},{"issue":"4","key":"1194_CR32","doi-asserted-by":"publisher","first-page":"294","DOI":"10.1016\/j.math.2012.10.013","volume":"18","author":"P Mota","year":"2013","unstructured":"Mota P, Pascoal AG, Sancho F, Carita AI, B\u00f8 K. Reliability of the inter-rectus distance measured by palpation. Comparison of palpation and ultrasound measurements. Manual Therapy. 2013;18(4):294\u20138.","journal-title":"Manual Therapy"}],"container-title":["BMC Women's Health"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12905-021-01194-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1186\/s12905-021-01194-8\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12905-021-01194-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,2,17]],"date-time":"2021-02-17T09:23:17Z","timestamp":1613553797000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcwomenshealth.biomedcentral.com\/articles\/10.1186\/s12905-021-01194-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,2,15]]},"references-count":32,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["1194"],"URL":"https:\/\/doi.org\/10.1186\/s12905-021-01194-8","relation":{},"ISSN":["1472-6874"],"issn-type":[{"value":"1472-6874","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,2,15]]},"assertion":[{"value":"26 September 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 January 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 February 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"This study was approved by the Ethics Committee of the Seventh Affiliated Hospital of Sun yet-san University (The certificate number was 2020SYSUSH-055). Professor Tian Li, who is the chief of the Centre of Pelvic Floor Rehabilitation of Gynaecology and Obstetric Department in the Seventh Affiliated Hospital of Sun yet-san University, and Hui Fei, Yun Liu were allowed to access and use the medical records described in this study.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"68"}}