Association between Delivery Mode and Diastasis Recti Abdominis in Postpartum Women.

BACKGROUND

Diastasis recti abdominis (DRA) significantly impairs the somatic and psychological well-being of postpartum women.

AIM: To explore the association between mode of delivery and postpartum DRA, providing a basis for the prevention of DRA.

METHODS

A total of 2,603 postpartum women who underwent examination at our hospital between January and December 2023 were included. DRA was operationally defined as a midline inter-recti distance >2 cm on ruler measurement. The study compared the basic characteristics between women who underwent cesarean delivery and those who underwent vaginal delivery. Logistic regression was used to assess the independent association between mode of delivery and DRA.

RESULTS

The incidence of DRA in the cesarean section group was 12.8%, which was higher than that in the vaginal delivery group (7.4%) (χ 2 = 21.0, P < 0.001). The women in the cesarean section group were older, had a higher proportion of two deliveries, a higher basal metabolic rate (BMI), and a heavier fetal weight (all P < 0.001). After adjusting for age, occupation, parity, history of abdominal surgery, BMI, and weight gain during pregnancy, compared to vaginal delivery, cesarean delivery was associated with 90% higher odds of DRA (95% confidence interval: 1.4-2.6. The stratified analysis revealed that in almost all subgroups with different characteristics, the incidence of DRA in the cesarean delivery group was higher than in the vaginal delivery group. Sensitivity analyses by restricting participants to those without preterm birth and episiotomy showed similar results.

CONCLUSION

Compared with vaginal delivery, the likelihood of developing postpartum DRA was higher in the cesarean section group.