Women's Health Outcomes After Traumatic Brain Injury
Women's Health Outcomes After Traumatic Brain Injury
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DOI：
10.1089/jwh.2009.1740
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发表时间：
2010-06-01
影响因子：
3.5
通讯作者：
Cullen, Nora
中科院分区：
文献类型：
--
作者：
Colantonio, Angela;Mar, Wanna;Cullen, Nora
背景：创伤性脑损伤(TBI)是一个重大的公共健康问题，但对这种损伤如何影响女性特有的长期结局却知之甚少。这项研究考察了绝经前妇女受伤后5-12年的健康结局。方法：这是一项在8个参与急性护理康复机构的回溯性队列研究。参与者是连续符合条件的中度到重度脑外伤患者。一项后续访谈评估了受伤前后的月经功能、生育力和怀孕经历，以及宫颈癌筛查。人口统计变量，自评一般和精神健康，以及功能限制也被收集。与伤害相关的信息从健康记录中提取。结果：在104名患有颅脑损伤(W-TBI)的女性中，46%的人闭经，持续时间长达60个月。68%的W-TBI患者伤后周期变得不规则。这些发现与对照组显著不同。在W-TBI中，月经紊乱与损伤严重程度相关。W-TBI和对照组在生育力方面没有差异，尽管W-TBI有一个或多个活产的明显较少，而且他们报告的产后困难比对照组更多。W-TBI患者进行常规巴氏涂片检查的可能性较小，并报告较低的心理健康、自评健康和功能。结论：这些发现为女性TBI后的预后提供了信息，并为长期监测健康结局和产后加强支持提供了证据。在这一领域需要更多的研究，特别是在神经内分泌系统方面。
Background: Traumatic brain injury (TBI) is a major public health problem, yet little is known about how this injury may affect long-term outcomes unique to women. This research examined the health outcomes relevant to premenopausal women 5-12 years after injury.Methods: This was a retrospective cohort study at eight participating acute care= rehabilitation facilities. Participants were consecutive eligible women with moderate to severe TBI. A follow-up interview assessed menstrual functioning, fertility, and pregnancy experiences before and after injury as well as cervical cancer screening. Demographic variables, self-rated general and mental health, and functional limitations were also collected. Injury-related information was abstracted from health records. Female control participants recruited were matched on age, education, and geographic location.Results: Of the 104 women with TBI (W-TBI), 46% experienced amenorrhea with duration of up to 60 months. Cycles became irregular for 68% of W-TBI after the injury. These findings were significantly different from those of controls. Among W-TBI, menstrual disturbances were associated with injury severity. No differences were shown between W-TBI and controls with respect to fertility, although significantly fewer W-TBI had one or more live births, and they reported more difficulties in the postpartum period than controls. W-TBI were less likely to have regular Pap smears and reported lower mental health, self-rated health, and function.Conclusions: These findings inform prognosis after TBI for women and provide evidence for long-term monitoring of health outcomes and increased support after childbirth. More research is needed in this area, particularly with respect to the neuroendocrine system.