Evaluation of Rectus Abdominis Muscle Using High-Frequency Ultrasound and Shear Wave Elastography to Construct a Risk Prediction Model for Postpartum Low Back Pain.

RATIONALE AND OBJECTIVES

This study aimed to develop a risk prediction model for low back pain (LBP) using high-frequency ultrasound to measure rectus abdominis muscle activity in postpartum women.

MATERIALS AND METHODS

This study included 197 pregnant women who delivered at our hospital and underwent routine postpartum follow-up. High-frequency ultrasound was used to assess the inter-rectus distance, thickness, and elasticity of the rectus abdominis muscle. Follow-up data were collected until six months after delivery, including information on LBP and exercise. Statistical analysis was performed to identify independent risk factors for postpartum LBP and build a risk prediction model.

RESULTS

Univariate and multivariate logistic regression analyses revealed that rectus abdominis thickness and exercise were significant independent factors associated with postpartum LBP. There was no significant correlation between rectus abdominis diastasis, body mass index (BMI), or LBP. The risk prediction model corresponding to the minimum AIC value (205.19) was Y= 8.16-1.13 ×thickness of the rectus abdominis-3.09 ×exercise. The ROC curve indicated that the optimal diagnostic cut-off value of the prediction model was 0.314, with an area under the curve (AUC) of 0.813. The sensitivity, specificity, positive and negative predictive values, and accuracy were 62.0%, 78.0%, 65.3%, 75.4%, and 71.6%, respectively.

CONCLUSION

A risk prediction model for postpartum LBP built using high-frequency ultrasound measurements of the rectus abdominis muscle may accurately predict postpartum LBP during the early postpartum period.