{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T04:58:30Z","timestamp":1790657910109,"version":"4.1.0"},"reference-count":26,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Diastasis recti abdominis (DRA) affects abdominal wall stability and is associated with low back pain and pelvic floor dysfunction. Early identification of high-risk individuals is important for prevention and individualized management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To develop and validate a clinical\u2013radiomics model based on early-pregnancy two-dimensional grayscale ultrasound images for predicting DRA at 42 days postpartum and establishing a risk stratification system.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This prospective study included 428 pregnant women at 5\u20138 gestational weeks, randomly divided into training (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009300) and testing (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009128) cohorts. Radiomic features were extracted from ultrasound images of the rectus abdominis and linea alba to construct Radscore1 and Radscore2. These scores were integrated with early-pregnancy BMI and exercise habits to develop a combined model. Model performance was evaluated using AUC, 10-fold cross-validation, Hosmer\u2013Lemeshow test, calibration curves, and decision curve analysis. A risk scoring system was constructed from regression coefficients. Spearman correlation analysis assessed associations with postpartum inter-rectus distance (IRD).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Radscore1, Radscore2, early-pregnancy BMI, and regular exercise were independently associated with DRA, with regular exercise showing a protective association. The combined model achieved AUCs of 0.892 and 0.859 in the training and testing cohorts, respectively. In the scoring system, BMI \u226524\u2005kg\/m\u00b2, absence of exercise habits, Radscore1\u2009\u2265\u20092.73, and Radscore2\u2009\u2265\u20091.85 were assigned 1, 1, 3, and 1 points, respectively. DRA incidence increased significantly with risk level (trend test,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001). Radscore1, Radscore2, early-pregnancy BMI, and rectus abdominis thickness were positively correlated with postpartum IRD.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The clinical\u2013radiomics model and risk scoring system accurately predicted DRA at 42 days postpartum and enabled early risk stratification, providing a quantitative basis for individualized intervention and follow-up. This is a single-center study; the findings require validation in independent multicenter cohorts before clinical implementation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1879674","type":"journal-article","created":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T04:34:06Z","timestamp":1790656446000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Predicting postpartum diastasis recti abdominis using early-pregnancy abdominal wall ultrasound radiomics"],"prefix":"10.3389","volume":"13","author":[{"given":"Bei","family":"Li","sequence":"first","affiliation":[{"name":"Department of Ultrasound, Zhenjiang Ruikang Hospital","place":["Zhenjiang, Jiangsu, China"]},{"name":"Department of Obstetrics, Affiliated Hospital of Jiangsu University","place":["Zhenjiang, Jiangsu, 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