{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T13:12:30Z","timestamp":1792761150173,"version":"4.5.0"},"reference-count":38,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,5,27]],"date-time":"2024-05-27T00:00:00Z","timestamp":1716768000000},"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. Physiol."],"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>To compare the inter-rectus distance (IRD), rectus abdominis thickness (RAT), and stiffness in women during pregnancy and postpartum and identify the risk and protective factors affecting diastasis recti abdominis (DRA).<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and methods<\/jats:title><jats:p>A total of 171 pregnant women who volunteered to participate in this study were recruited. Using an ultrasonographic diagnostic instrument with shear wave elastography function, IRD, RAT and the Young\u2019s modulus of the rectus abdominis muscles were measured at 12\u00a0weeks, 37\u00a0weeks of pregnancy, and 6\u00a0weeks postpartum.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The IRD at 37\u00a0weeks was significantly higher than that at 12\u00a0weeks and then decreased at 6\u00a0weeks postpartum, but it was still higher than that at 12\u00a0weeks (<jats:italic>p<\/jats:italic> &amp;lt; 0.001). RAT and Young\u2019s modulus decreased significantly at 37\u00a0weeks compared with those at 12\u00a0weeks and then recovered at 6\u00a0weeks postpartum, but they were lower than those at 12\u00a0weeks (<jats:italic>p<\/jats:italic> &amp;lt; 0.001). IRD at 12\u00a0weeks was significantly higher in multiparae than in primiparae (<jats:italic>p<\/jats:italic> &amp;lt; 0.001). Moreover, positive correlation between the RAT and Young\u2019s modulus of rectus abdominis muscles at 12 and 37\u00a0weeks of gestation and 6\u00a0weeks postpartum (<jats:italic>p<\/jats:italic> &amp;lt; 0.001) was observed. Multiple linear regression analysis showed that the regression equation was significant (f = 24.856, <jats:italic>p<\/jats:italic> &amp;lt; 001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our study identified differences in IRD, thickness and stiffness of the rectus abdominis muscle between early and advanced pregnancy and the postpartum period. The risk and protective factors of DRA may guide pregnant women\u2019s protection and treatment.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fphys.2024.1382982","type":"journal-article","created":{"date-parts":[[2024,5,27]],"date-time":"2024-05-27T04:25:11Z","timestamp":1716783911000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["A prospective study of two-dimensional ultrasonography combined with shear wave elastography for pregnancy-related diastasis recti abdominis"],"prefix":"10.3389","volume":"15","author":[{"given":"Li","family":"Wang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ting","family":"Yun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dong","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianrong","family":"Zhong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan","family":"Yi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wanxi","family":"Fu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Molin","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunshan","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuexiang","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,5,27]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"e542","DOI":"10.5114\/pjr.2019.91303","article-title":"Diastasis of rectus abdominis muscles: patterns of anatomical variation as demonstrated by ultrasound","volume":"84","author":"Antonio","year":"2020","journal-title":"Pol. J. Radiol."},{"key":"B2","doi-asserted-by":"publisher","first-page":"297","DOI":"10.1148\/radiol.10090385","article-title":"Breast lesions: quantitative elastography with supersonic shear imaging--preliminary results","volume":"256","author":"Athanasiou","year":"2010","journal-title":"Radiology"},{"key":"B3","doi-asserted-by":"publisher","first-page":"187","DOI":"10.23736\/S2724-5691.20.08404-7","article-title":"Laparoscopic diastasis recti abdominis and midline hernia repair","volume":"76","author":"Barbato","year":"2021","journal-title":"Minerva. Surg."},{"key":"B4","doi-asserted-by":"publisher","first-page":"24","DOI":"10.1016\/j.physio.2018.07.002","article-title":"Relationship between diastasis of the rectus abdominis muscle (DRAM) and musculoskeletal dysfunctions, pain and quality of life: a systematic review","volume":"105","author":"Benjamin","year":"2019","journal-title":"Physiotherapy"},{"key":"B5","doi-asserted-by":"publisher","first-page":"716","DOI":"10.1002\/nau.23005","article-title":"Pelvic floor muscle function, pelvic floor dysfunction and diastasis recti abdominis: prospective cohort study","volume":"36","author":"Bo","year":"2017","journal-title":"Neurourol. Urodyn."},{"key":"B6","doi-asserted-by":"publisher","first-page":"1082","DOI":"10.1093\/ptj\/68.7.1082","article-title":"Incidence of diastasis recti abdominis during the childbearing year","volume":"68","author":"Boissonnault","year":"1988","journal-title":"Phys. Ther."},{"key":"B8","doi-asserted-by":"publisher","first-page":"505","DOI":"10.1088\/0031-9155\/59\/3\/505","article-title":"In vivo evaluation of the elastic anisotropy of the human Achilles tendon using shear wave dispersion analysis","volume":"59","author":"Brum","year":"2014","journal-title":"Phys. Med. Biol."},{"key":"B9","doi-asserted-by":"publisher","first-page":"1077","DOI":"10.1093\/ptj\/67.7.1077","article-title":"Interrater reliability of diastasis recti abdominis measurement","volume":"67","author":"Bursch","year":"1987","journal-title":"Phys. Ther."},{"key":"B10","first-page":"239","article-title":"Musculoskeletal sonoelastography. Pictorial essay","volume":"14","author":"Carolina","year":"2012","journal-title":"Med. Ultrason."},{"key":"B11","doi-asserted-by":"publisher","first-page":"465","DOI":"10.1007\/s10029-014-1221-0","article-title":"Analysis of the abdominal musculo-aponeurotic anatomy in rectus diastasis: comparison of CT scanning and preoperative clinical assessment with direct measurement intraoperatively","volume":"18","author":"Emanuelsson","year":"2014","journal-title":"Hernia"},{"key":"B12","doi-asserted-by":"publisher","first-page":"260","DOI":"10.1186\/s12905-020-01123-1","article-title":"Women's experiences of living with increased inter-recti distance after childbirth: an interview study","volume":"20","author":"Eriksson Crommert","year":"2020","journal-title":"BMC Womens Health"},{"key":"B13","doi-asserted-by":"publisher","first-page":"200","DOI":"10.1016\/j.math.2014.09.002","article-title":"Prevalence and risk factors of diastasis recti abdominis from late pregnancy to 6 months postpartum, and relationship with lumbo-pelvic pain","volume":"20","author":"Fernandes da Mota","year":"2015","journal-title":"Man. Ther."},{"key":"B14","doi-asserted-by":"publisher","first-page":"428","DOI":"10.1186\/s12905-022-02009-0","article-title":"Primiparous women's knowledge of diastasis recti abdominis, concerns about abdominal appearance, treatments, and perceived abdominal muscle strength 6-8 months postpartum. A cross sectional comparison study","volume":"22","author":"Gluppe","year":"2022","journal-title":"BMC women's health"},{"key":"B15","doi-asserted-by":"publisher","first-page":"525","DOI":"10.1002\/jum.16384","article-title":"Multidimensional ultrasound evaluation of diastasis recti abdominis during different gestational periods","volume":"43","author":"Guo","year":"2024","journal-title":"J. ultrasound Med."},{"key":"B16","doi-asserted-by":"publisher","first-page":"293","DOI":"10.1016\/j.actbio.2018.12.002","article-title":"Guided wave elastography of layered soft tissues","volume":"84","author":"Guo-Yang","year":"2018","journal-title":"Acta Biomater."},{"key":"B17","doi-asserted-by":"publisher","first-page":"10","DOI":"10.9738\/INTSURG-D-15-00204.1","article-title":"Severe irreversible diastasis recti abdominis and abdominal hernia in postpartum women: rare case report","volume":"105","author":"Ha","year":"2016","journal-title":"Int. Surg."},{"key":"B18","doi-asserted-by":"publisher","first-page":"87","DOI":"10.1186\/s13244-021-01021-6","article-title":"Muscle elasticity is different in individuals with diastasis recti abdominis than healthy volunteers","volume":"12","author":"He","year":"2021","journal-title":"Insights Imaging"},{"key":"B19","doi-asserted-by":"publisher","first-page":"282","DOI":"10.1186\/s12891-021-04157-0","article-title":"Extended field-of-view ultrasound imaging is reliable for measuring Transversus Abdominis muscle size at rest and during contraction","volume":"22","author":"Johnson","year":"2021","journal-title":"BMC Musculoskelet. Disord."},{"key":"B20","doi-asserted-by":"publisher","first-page":"24","DOI":"10.1016\/j.ejogrb.2023.03.040","article-title":"Comparison of the efficiency of core stabilization exercises and abdominal corset in the treatment of postpartum diastasis recti abdominis","volume":"285","author":"Kaya","year":"2023","journal-title":"Eur. J. obstetrics, Gynecol. reproductive Biol."},{"key":"B21","doi-asserted-by":"publisher","first-page":"382","DOI":"10.1016\/j.acra.2021.06.005","article-title":"Rectus abdominis muscle thickness is a valid measure of cross-sectional area: implications for ultrasound","volume":"29","author":"Kelly","year":"2022","journal-title":"Acad. Radiol."},{"key":"B22","doi-asserted-by":"publisher","first-page":"182","DOI":"10.1093\/ptj\/pzx117","article-title":"Relationship between interrectus distance and symptom severity in women with diastasis recti abdominis in the early postpartum period","volume":"98","author":"Keshwani","year":"2018","journal-title":"Phys. Ther."},{"key":"B23","doi-asserted-by":"publisher","first-page":"713","DOI":"10.2519\/jospt.2015.5879","article-title":"Ultrasound imaging in postpartum women with diastasis recti: intrarater between-session reliability","volume":"45","author":"Keshwani","year":"2015","journal-title":"J. Orthop. Sports Phys. Ther."},{"key":"B24","doi-asserted-by":"publisher","first-page":"320","DOI":"10.1111\/cpf.12763","article-title":"Assessing the differences in muscle stiffness measured with shear wave elastography and myotonometer during the menstrual cycle in young women","volume":"42","author":"Khowailed","year":"2022","journal-title":"Clin. physiology Funct. imaging"},{"key":"B25","doi-asserted-by":"publisher","first-page":"182","DOI":"10.1590\/s0102-86502007000300005","article-title":"Ultrasonography for measuring rectus abdominis muscles diastasis","volume":"22","author":"Mendes Dde","year":"2007","journal-title":"Acta Cir. Bras."},{"key":"B26","doi-asserted-by":"publisher","first-page":"97","DOI":"10.5603\/GP.a2018.0016","article-title":"Diastasis recti abdominis - a review of treatment methods","volume":"89","author":"Michalska","year":"2018","journal-title":"Ginekol. Pol."},{"key":"B27","doi-asserted-by":"publisher","first-page":"351","DOI":"10.1002\/mus.27129","article-title":"Relationship between ultrasonographic hand muscle thickness measurements and muscle strength following median or ulnar nerve reconstruction","volume":"63","author":"Misirlioglu","year":"2021","journal-title":"Muscle and nerve"},{"key":"B28","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1016\/j.msksp.2018.02.004","article-title":"Normal width of the inter-recti distance in pregnant and postpartum primiparous women","volume":"35","author":"Mota","year":"2018","journal-title":"Musculoskelet. Sci. Pract."},{"key":"B29","first-page":"69","article-title":"Statistics corner: a guide to appropriate use of correlation coefficient in medical research","volume":"24","author":"Mukaka","year":"2012","journal-title":"Malawi Med. J."},{"key":"B30","doi-asserted-by":"publisher","first-page":"656","DOI":"10.2519\/jospt.2019.8543","article-title":"Differences in linea alba stiffness and linea alba distortion between women with and without diastasis recti abdominis: the impact of measurement site and task","volume":"49","author":"Nicole","year":"2019","journal-title":"J. Orthop. Sports Phys. Ther."},{"key":"B31","doi-asserted-by":"publisher","first-page":"750","DOI":"10.1002\/bjs5.50213","article-title":"Cohort study of the effect of surgical repair of symptomatic diastasis recti abdominis on abdominal trunk function and quality of life","volume":"3","author":"Olsson","year":"2019","journal-title":"BJS Open"},{"key":"B32","doi-asserted-by":"publisher","first-page":"940","DOI":"10.2519\/jospt.2012.4115","article-title":"Test-retest and intrarater reliability of 2-dimensional ultrasound measurements of distance between rectus abdominis in women","volume":"42","author":"Patricia","year":"2012","journal-title":"J. Orthop. Sports Phys. Ther."},{"key":"B33","doi-asserted-by":"publisher","first-page":"8234","DOI":"10.26355\/eurrev_202309_33584","article-title":"The role of component separation in the treatment of severe diastasis recti abdominis: a new indication for a known technique","volume":"27","author":"Redi","year":"2023","journal-title":"Eur. Rev. Med. Pharmacol. Sci."},{"key":"B34","doi-asserted-by":"publisher","first-page":"515","DOI":"10.2307\/2531456","article-title":"A modified Bonferroni method for discrete data","volume":"46","author":"R E","year":"1990","journal-title":"Biometrics"},{"key":"B35","doi-asserted-by":"publisher","first-page":"1609798","DOI":"10.3389\/pore.2021.1609798","article-title":"Comparison of shear wave elastography and dynamometer test in muscle tissue characterization for potential medical and sport application","volume":"27","author":"Soldos","year":"2021","journal-title":"Pathology Oncol. Res. POR"},{"key":"B36","doi-asserted-by":"publisher","first-page":"1092","DOI":"10.1136\/bjsports-2016-096065","article-title":"Diastasis recti abdominis during pregnancy and 12 months after childbirth: prevalence, risk factors and report of lumbopelvic pain","volume":"50","author":"Sperstad","year":"2016","journal-title":"Br. J. Sports Med."},{"key":"B37","first-page":"817","article-title":"Prevalence of diastasis recti abdominis in the population of young multiparous adults in Turkey","volume":"82","author":"Turan","year":"2011","journal-title":"Ginekol. Pol."},{"key":"B38","doi-asserted-by":"publisher","first-page":"518","DOI":"10.1111\/jocn.15568","article-title":"Diastasis recti abdominis in adult women based on abdominal computed tomography imaging: prevalence, risk factors and its impact on life","volume":"30","author":"Wu","year":"2021","journal-title":"J. Clin. Nurs."},{"key":"B39","doi-asserted-by":"publisher","first-page":"1725","DOI":"10.1123\/ijspp.2022-0094","article-title":"Association of muscle strength with muscle thickness and motor unit firing pattern of vastus lateralis muscle in youth athletes","volume":"17","author":"Yoshimura","year":"2022","journal-title":"Int. J. sports physiology Perform."}],"container-title":["Frontiers in Physiology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fphys.2024.1382982\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,27]],"date-time":"2024-05-27T04:25:17Z","timestamp":1716783917000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fphys.2024.1382982\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5,27]]},"references-count":38,"alternative-id":["10.3389\/fphys.2024.1382982"],"URL":"https:\/\/doi.org\/10.3389\/fphys.2024.1382982","relation":{},"ISSN":["1664-042X"],"issn-type":[{"value":"1664-042X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,5,27]]},"article-number":"1382982"}}