ABSTRACT
Objective:To investigate the prevalence, risk factors and outcomes of diastasis recti abdominis (DRA) in multiparas after the second delivery.Methods:From June 2017 to September 2019, 300 multiparas with an average age of (31.7±4.0) years (26 to 43 years) after the second delivery were recruited at 6 weeks postpartum from two hospitals in Wenzhou. There were 171 multiparas with two natural births,36 multiparas with one natural birth and one caesarean delivery, and 93 multiparas with two caesarean deliveries. The interrectus distance (IRD) was measured with palpation at 6 weeks, 6 months and 12 months after delivery. Data on age, height, weight before pregnancy and delivery, baby′s birth weight, abdominal circumference before pregnancy and delivery, fetus number, delivery mode and occupation type were collected. Strength and endurance of abdominal muscle was assessed using manual muscle testing and curl-ups, low back pain was assessed using Oswestry disability index(ODI), urinary incontinence was assessed with International Consultation on Incontinence guestionnaire-incontinentia urinae (ICIQ-UI) short form (ICIQ-SF), and quality of life was assessed using 36-item short form health survey (SF-36).Results:Prevalence of DRA was 51.7%(155/300), 39.3%(116/295) and 27.7%(80/289) 6 weeks, 6 months and 12 months after delivery, respectively. Logistic regression analysis indicated that age ( OR=1.39, 95 %CI:1.02-1.91, P=0.38), abdominal circumference ratio ( OR=2.31, 95 %CI:1.23-4.33, P=0.01), twins ( OR=11.41, 95 %CI:2.15-60.76, P<0.01), and cesarean section ( OR=1.44, 95 %CI:1.06-1.95, P=0.02) were the risk factors of DRA at 12 months after delivery. At 12 months after delivery, the multiparas with DRA had weaker strength and endurance of abdominal muscle ( Z=-3.62, P<0.01; Z=-8.91, P<0.01), more serious low back pain ( Z=-2.10, P=0.04), and lower quality of life on physical health ( t=-3.34, P<0.01) than the multiparas without DRA. No difference in prevalence and severity of urinary incontinence and quality of life on psychological health was found when comparing multiparas with and without DRA (χ 2=0.66, P=0.42; Z=-1.18, P=0.24; t=0.91, P=0.36). Conclusion:Multipara after the second delivery has great likelihood for DRA.Age, abdominal circumference ratio, twins, and cesarean section are the risk factors of DRA. DRA is related to abdominal muscle dysfunction, low back pain, and quality of life.
ABSTRACT
To explore the serum miR-338-5p expression characteristics in renal transplant recipients ,and the role of regulating BAFF signal ,then investigate its biological significance.Methods:Healthy volunteers were enrolled as control group.Serum miR-338-5p was detected by real-time PCR;soluble BAFF was detected by ELISA;anti-HLA-Ⅰantibody,anti-HLA-Ⅱ antibody and anti-MICA antibody were detected by liquid chip technology.SPSS17.0 software was applied.t-test was used to compare the means of two independent samples;Paired samples t-test was used to compare the means of two paired samples;Spearman method and Pearson method were used to analyse the correlation;P<0.05 was considered to be statistically significant.Results: Compared with healthy controls,serum miR-338-5p in renal transplant recipients decreased significantly (P<0.001),while serum BAFF increased significantly (P<0.01).Serum miR-338-5p levels within 1 year post-transplantation were significantly lower than that of more than 1 year post-transplantation (P<0.01);Serum miR-338-5p levels within 3 years post-transplantation were significantly lower than that of more than 3 years post-transplantation (P<0.01);To all research objects,serum miR-338-5p was significantly negatively correlated with serum BAFF (r=-0.51,P<0.001),and serum miR-338-5p was significantly negatively correlated with anti-HLA-Ⅱ antibody(r=-0.322, P<0.05);Serum miR-338-5p within 3 years was significantly negatively correlated with anti-HLA-Ⅱantibody (r=-0.423,P<0.05), and serum miR-338-5p within 3 years was significantly negatively correlated with anti-MICA antibody(r=-0.411,P<0.05);Serum miR-338-5p more than 3 years was significantly positively correlated with anti-MICA antibody(r=0.486,P<0.05),and Serum miR-338-5p more than 3 years was significantly positively correlated with anti-HLA & MICA antibody(r=0.578,P<0.01).Conclusion:miR-338-5p may directly or indirectly target BAFF signal ,and participate antibody mediated immune response by regulating its target genes and interfere with the long-term survival of transplanted renal.