Association Between Self-Reported Symptoms of DRA and Low Back Pain, Pelvic Girdle Pain, and Pelvic Floor Dysfunction 6–8 Months Postpartum: A Cross-Sectional Survey of 460 Primiparous Participants

Purpose: Diastasis recti abdominis (DRA) is common postpartum, but its association with low back pain (LBP), pelvic girdle pain (PGP), and pelvic floor dysfunction (PFD) remains unclear due to inconsistent findings. Women reporting visible protrusion or hollowing along the linea alba were considered to have DRA. The aim was to compare the prevalence of and risk factors for LBP, PGP, and PFD among primiparous participants with and without self-reported symptoms of DRA 6–8 months postpartum. Methods: This cross-sectional study included 460 primiparous participants. Data were collected using a web-based questionnaire assessing DRA (including photos of abdominal protrusion/hollowing), LBP, PGP, and PFD. Validated outcome measures included the Oswestry Disability Index, Pelvic Girdle Questionnaire, and Pelvic Floor Distress Inventory-Short Form 20. Results: Of 436 respondents, 96 (22%) reported DRA. There were no differences between groups in LBP prevalence or severity. A higher proportion of participants with self-reported symptoms of DRA reported PGP (45.3% vs. 23.9%), but no between-group differences were found in PGP severity. There were no differences in the prevalence of PFD. Mean Pelvic Floor Distress Inventory-Short Form 20 total scores were higher among participants with self-reported symptoms of DRA (81.7 ± 53.2 vs. 58.3 ± 35.6), although this difference was not observed in subscale analyses. Discussion: Self-reported symptoms of DRA were associated with a higher prevalence of PGP, but not with LBP or PFD, at 6–8 months postpartum. These findings contribute to the evidence base and may support pelvic health physical therapists providing evidence-informed counseling to women concerned about DRA and related symptoms.