Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland.
Department of Pediatrics, Mikkeli Central Hospital, Mikkeli, Finland.
J Matern Fetal Neonatal Med. 2022 Dec;35(25):9709-9716. doi: 10.1080/14767058.2022.2050899. Epub 2022 Mar 13.
Few studies have assessed pregnancies and deliveries after traumatic brain injury (TBI). We report the incidence of TBIs and TBI-related surgeries in fertile-aged females and investigate subsequent pregnancy outcomes.
All fertile-aged (15-49) women with TBI diagnosis during our study period (1998-2018) were retrieved from the Care Register for Health Care and combined with data from the National Medical Birth Register. TBIs were categorized into three subgroups based on the length of the hospitalization period and the need for neurosurgery. Logistic regression was used to analyze preterm deliveries, cesarean sections (CS) and neonatal health. Results are reported as adjusted odds ratios (AOR) with 95% confidence intervals (CI).
The incidence of TBIs increased from 103 per 100 000 person-years in 1998 to 257 per 100 000 (149.5%) in 2018. The incidence of TBI-related surgeries remained stable during our study period. The rate of preterm deliveries was 5.6% in the TBI group and 3.0% in the control group (AOR 1.23, CI 1.17-1.28). The CS rate in the TBI group was 19.2% and 15.9% in the control group (AOR 1.23, CI 1.18-1.29). The use of labor analgesia was higher among women with previous TBI. The rate of neonates requiring intensive care in the TBI group was 13.1% and 9.9% in the control group (AOR 1.30, CI 1.24-1.37).
The incidence of TBI hospitalizations increased during our study period, whereas the number of surgically treated TBI remained stable. Preterm deliveries, CS, instrumental vaginal deliveries and labor analgesia were more prevalent in women with previous TBI. Furthermore, more neonates required intensive care in this group. Therefore, a history of TBI should be acknowledged as a possible factor affecting the delivery and health of the neonate.
鲜有研究评估颅脑创伤（TBI）后妊娠和分娩的情况。我们报告了育龄期女性 TBI 及 TBI 相关手术的发生率，并对后续妊娠结局进行了调查。
检索了我们研究期间（1998 年至 2018 年）所有育龄期（15-49 岁）TBI 诊断患者的病历，并与国家围产儿医学登记数据库中的数据进行了合并。根据住院时间长短和是否需要神经外科手术，TBI 分为三个亚组。采用 logistic 回归分析早产、剖宫产（CS）和新生儿健康的情况。结果以调整后的比值比（AOR）及其 95%置信区间（CI）表示。
TBI 的发生率从 1998 年的每 10 万人年 103 例上升至 2018 年的每 10 万人年 257 例（149.5%）。TBI 相关手术的发生率在研究期间保持稳定。TBI 组的早产率为 5.6%，对照组为 3.0%（AOR 1.23，CI 1.17-1.28）。TBI 组 CS 率为 19.2%，对照组为 15.9%（AOR 1.23，CI 1.18-1.29）。有 TBI 病史的女性使用分娩镇痛的比例更高。TBI 组需要重症监护的新生儿比例为 13.1%，对照组为 9.9%（AOR 1.30，CI 1.24-1.37）。
研究期间 TBI 住院率增加，而接受手术治疗的 TBI 数量保持稳定。有 TBI 病史的女性早产、CS、产钳助产和分娩镇痛更为常见。此外，该组需要重症监护的新生儿更多。因此，TBI 史应被视为影响分娩和新生儿健康的一个可能因素。
