title: Pelvic floor muscle function, pelvic floor dysfunction and diastasis recti abdominis: Prospective cohort study.
abstract: Compare vaginal resting pressure (VRP), pelvic floor muscle (PFM) strength, and endurance in women with and without diastasis recti abdominis at gestational week 21 and at 6 weeks, 6 months, and 12 months postpartum. Furthermore, to compare prevalence of urinary incontinence (UI) and pelvic organ prolapse (POP) in the two groups at the same assessment points.
  
  
  
  This is a prospective cohort study following 300 nulliparous pregnant women giving birth at a public university hospital. VRP, PFM strength, and endurance were measured with vaginal manometry. ICIQ-UI-SF questionnaire and POP-Q were used to assess UI and POP. Diastasis recti abdominis was diagnosed with palpation of  ≥2 fingerbreadths 4.5 cm above, at, or 4.5 cm below the umbilicus.
  
  
  
  At gestational week 21 women with diastasis recti abdominis had statistically significant greater VRP (mean difference 3.06 cm H2O [95%CI: 0.70; 5.42]), PFM strength (mean difference 5.09 cm H2O [95%CI: 0.76; 9.42]) and PFM muscle endurance (mean difference 47.08 cm H2O sec [95%CI: 15.18; 78.99]) than women with no diastasis. There were no statistically significant differences between women with and without diastasis in any PFM variables at 6 weeks, 6 months, and 12 months postpartum. No significant difference was found in prevalence of UI in women with and without diastasis at any assessment points. Six weeks postpartum 15.9% of women without diastasis had POP versus 4.1% in the group with diastasis (P = 0.001).
  
  
  
  Women with diastasis were not more likely to have weaker PFM or more UI or POP. Neurourol. Urodynam. 36:716-721, 2017. © 2016 Wiley Periodicals, Inc.
authors.affiliation: Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway.|Department of Obstetrics and Gynaecology, Akershus University Hospital, Lørenskog, Norway.
authors.forename: Kari
authors.initials: K
authors.lastname: Bø
authors.affiliation: Department of Obstetrics and Gynaecology, Akershus University Hospital, Lørenskog, Norway.
authors.forename: Gunvor
authors.initials: G
authors.lastname: Hilde
authors.affiliation: Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway.
authors.forename: Merete Kolberg
authors.initials: MK
authors.lastname: Tennfjord
authors.affiliation: Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway.
authors.forename: Jorun Bakken
authors.initials: JB
authors.lastname: Sperstad
authors.affiliation: Department of Obstetrics and Gynaecology, Akershus University Hospital, Lørenskog, Norway.|Faculty of Medicine, University of Oslo, and Akershus University Hospital, Oslo, Norway.
authors.forename: Marie Ellstrøm
authors.initials: ME
authors.lastname: Engh
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008365:Manometry; D053580:Muscle Strength / Q000502:physiology*; D017773:Pelvic Floor / Q000503:physiopathology*; D056887:Pelvic Organ Prolapse / Q000503:physiopathology*; D011247:Pregnancy; D011446:Prospective Studies; D017568:Rectus Abdominis / Q000503:physiopathology; D014549:Urinary Incontinence / Q000503:physiopathology*; D014621:Vagina / Q000503:physiopathology; D055815:Young Adult
keywords: diastasis recti abdominis; pelvic floor muscles; pelvic organ prolapse; postpartum; pregnancy; urinary incontinence