Does abdominal diastasis influence lumbar pain during gestation?

ABSTRACT BACKGROUND AND OBJECTIVES: To evaluate and compare the presence and size of recti abdominis diastasis in the second and third gestational trimester and to correlate them to lumbar pain incidence and intensity. METHODS: This is a cross-sectional observational study with 128 pregnant women divided in two groups: 53 pregnant women in the second gestational trimester and 75 pregnant women in the third gestational trimester. Lumbar pain was evaluated with Roland Morris questionnaire and Pain Visual Analog Scale. Recti abdominis diastasis was measured with a caliper rule. Data were analyzed according to Spearman correlation and Mann-Whitney U test. RESULTS: Comparison between groups has shown that pregnant women in the third gestational trimester had more recti abdominis diastasis, more reports of severe lumbar pain by the visual analog scale (p=0.0017) and further impact on daily life activities (p=0.0012). There has been positive correlation between recti abdominis diastasis size and scores obtained by Roland Morris questionnaire and visual analog scale. CONCLUSION: Recti abdominis diastasis size, pain intensity and incapacity determined by low back pain were more severe in pregnant women in the third gestational trimester.

摘要 背景与目的：评估并比较妊娠中期与妊娠晚期孕妇腹直肌分离（recti abdominis diastasis）的发生情况及分离程度，并分析其与腰痛发生率及疼痛强度的相关性。
方法：本研究为横断面观察性研究，共纳入128名孕妇，分为两组：妊娠中期孕妇53名，妊娠晚期孕妇75名。腰痛采用罗兰-莫里斯问卷（Roland Morris questionnaire）及疼痛视觉模拟评分法（Pain Visual Analog Scale）进行评估；腹直肌分离程度采用游标卡尺测量。数据采用斯皮尔曼相关性分析（Spearman correlation）及曼-惠特尼U检验（Mann-Whitney U test）进行统计学分析。
结果：组间比较显示，妊娠晚期孕妇的腹直肌分离程度更显著，视觉模拟评分提示其重度腰痛报告率更高（p=0.0017），且对日常活动的影响更为严重（p=0.0012）。腹直肌分离程度与罗兰-莫里斯问卷得分及视觉模拟评分呈正相关。
结论：妊娠晚期孕妇的腹直肌分离程度、腰痛强度及腰痛所致的功能障碍均较妊娠中期孕妇更为严重。