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Delivery Mode is Associated with Rectus Abdominis Diastasis: A Retrospective Cohort Study
Abstract Number: F3C-498
Abstract Type: Original Research
The prevalence of rectus abdominis diastasis (RAD) is estimated at from 38% to 52%. RAD could be exacerbated by posture change and induce back strain due to reduced strength and function of the muscles. The aim of our study was to evaluate the association between delivery mode (DM) and RAD and other potential risk factors that may have impacts on RAD.
With IRB approval, medical records of patients with diagnosis of RAD from 01/01/2009 to 12/31/2018 who delivered at the hospitals of Partner HealthCare System were collected. Data including demographic information, diagnosis, operative notes, imaging reports and procedures were collected. Other potential concomitant risk factors including anesthesia mode, delivery frequency, noted adhesions in pelvic and abdominal cavity and coexisted conditions were also collected. Risk ratio was used to calculate the relative risk. Crosstabs analysis was used for analysis of differences among groups.
A total of 317 patients with RAD diagnosis whose delivery operative notes were identified. Women who delivered via cesarean operation demonstrated 4.7 times greater risk of RAD than those women who never delivered via cesarean. Our subgroup analysis among the women who underwent one or more cesarean deliveries demonstrated that the frequency of adhesions in the abdominal or pelvic cavity increased with the number of cesarean deliveries(p=0.000). Neither low back pain nor hernia had significant associations with delivery mode and cesarean delivery frequency.
Previous studies reported RAD is common during and after pregnancy. However, we failed in identifying published study concerning the association between delivery mode and RAD. Our study demonstrated a positive association between the delivery mode and RAD occurrence, indicating that cesarean delivery mode could be an important risk factor. Meanwhile, we also found that frequency of cesarean delivery might be a risk factor to the occurrence of adhesions in abdominal and/or pelvic cavity among women experienced such delivery. We did not detect significant associations concerning the occurrence of either low back pain or hernia in patients with RAD experienced delivery between different delivery mode. Further study is warranted to examine this potentially devastating condition.
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