Abstract
Objectives: Hernias are very common in patients with rectus abdominis diastasis (RAD). This study aimed to identify and compare the risk factors and patterns of hernia between men and women with RAD.Method: We included patients with RAD from six hospitals within the Partners Healthcare System in Massachusetts, USA between 2009 and 2018. Univariate and multivariable binary logistic regression analyses were used to identify risk factors associated with hernia.Results: Of the 1,294 RAD cases, 866 (67%) were women. The risk of RAD in women was 1.9 times greater than that of men. There were 240 men (56.1%) and 310 women (35.8%) having one or more hernia (P < 0.001). Of the 550 hernia cases, 278 men and 175 women had umbilical hernia (28.1 vs. 38.3%, P = 0.085). The distribution of hernia type differed between the two groups (P < 0.0001). Multivariate analysis identified that alcohol use [odd ratio (OR) 1.74 (1.17–2.59); P = 0.006] and depressive disorder [OR 1.90 (1.209–2.998); P = 0.005] were risk factors of coexisting hernia for men with RAD; age [OR 1.51 (1.33–1.72); P = 0.000] and smoking/tobacco use [OR 1.66 (1.13–2.44); P = 0.010] were risk factors of hernia for women.Conclusion: The prevalence and risk factors of hernia in women with RAD significantly differed from that in men with RAD. Umbilical hernia is an important type of hernia. Alcohol use and depressive disorder in men, and age and smoking in women were risk factors of hernias in patients with RAD.
Highlights
Rectus abdominis diastasis (RAD) is characterized by the thinning and widening of the linea alba, which is defined as an interrectus distance of or more than 22 mm at 3 cm above the umbilicus when measured in a relaxed state [1]
For men with RAD, multivariate analysis identified that alcohol use (OR, 1.74; 95% confidence interval (CI), 1.17–2.59; P = 0.006) and depressive disorder (OR, 1.90; 95% CI, 1.209–2.998; P = 0.005) were risk factors of coexisting hernia (Table 4); for women with RAD, age (OR, 1.51; 95% CI, 1.33–1.72; P = 0.000) and smoking/tobacco use (OR, 1.66; 95% CI, 1.13–2.44; P = 0.010) were risk factors of coexisting hernia (Table 5)
Given the characteristics mentioned above and the data presented in previous findings, it is reasonable to infer that pregnancy, delivery, and cesarean delivery (CD) might be important factors leading to the development of RAD in female population, but the precise mechanism has not been well-recognized yet
Summary
Rectus abdominis diastasis (RAD) is characterized by the thinning and widening of the linea alba, which is defined as an interrectus distance of or more than 22 mm at 3 cm above the umbilicus when measured in a relaxed state [1]. Patients usually present with a protruding midline following an increase in intraabdominal pressure. It is more common in obese middle-aged and older men and in women of reproductive age [2, 3]. A high prevalence is found among women who Hernia Risk in Rectus Abdominis Diastasis underwent abdominal hysterectomies or hernia repair (38–52%) and among women during their third trimester of pregnancy (66–100%) [4,5,6]. Hernias were the most common [8,9,10,11,12]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
