Center for Injury Research and Prevention, Children's Hospital of Philadelphia, Philadelphia, PA.
Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; Division of Endocrinology and Diabetes, Children's Hospital of Philadelphia, Philadelphia, PA.
J Pediatr. 2023 Nov;262:113349. doi: 10.1016/j.jpeds.2023.02.002. Epub 2023 Feb 15.
To describe menstrual cycle patterns in adolescents with concussion and investigate whether menstrual cycle phase at injury influenced postconcussion cycle pattern changes or concussion symptoms.
Data were collected prospectively from patients aged 13-18 years presenting to a specialty care concussion clinic for an initial visit (≤28 days postconcussion) and, if clinically indicated, at a follow-up visit 3-4 months postinjury. Primary outcomes included menstrual cycle pattern change since injury (change/no change), menstrual cycle phase at time of injury (calculated using date of last period before injury), and symptom endorsement and severity, measured by Post-Concussion Symptom Inventory (PCSI). Fisher exact tests were used to determine the association between menstrual phase at injury and change in cycle pattern. Multiple linear regression was used to determine whether menstrual phase at injury was associated with PCSI endorsement and symptom severity, adjusting for age.
Five hundred twelve postmenarchal adolescents were enrolled (age 15.2 ± 1.4 years), with 111 (21.7%) returning for follow-up at 3-4 months. Menstrual pattern change was reported by 4% of patients at initial visit and 10.8% of patients at follow-up. At 3-4 months, menstrual phase at injury was not associated with menstrual cycle changes (P = .40) but was associated with endorsement of concussion symptoms on the PCSI (P = .01).
At 3-4 months' postconcussion, 1 in 10 adolescents experienced a change in menses. Menstrual cycle phase at injury was associated with postconcussion symptom endorsement. Leveraging a large sample of postconcussion menstrual patterns, this study represents foundational data regarding potential menstrual cycle effects of concussion in female adolescents.
描述脑震荡青少年的月经周期模式，并探讨损伤时的月经周期阶段是否影响脑震荡后周期模式的变化或脑震荡症状。
从 13-18 岁的患者中前瞻性收集数据，这些患者在初次就诊（脑震荡后≤28 天）时就诊于专门的脑震荡诊所，并且如果临床需要，在受伤后 3-4 个月进行随访。主要结局包括自损伤以来月经周期模式的变化（变化/无变化）、损伤时的月经周期阶段（根据损伤前最后一次月经的日期计算）以及使用脑震荡后症状清单（PCSI）测量的症状发生和严重程度。Fisher 确切检验用于确定损伤时的月经阶段与周期模式变化之间的关联。多元线性回归用于确定损伤时的月经阶段是否与 PCSI 的发生和症状严重程度相关，同时调整年龄。
共纳入 512 名初潮后青少年（年龄 15.2±1.4 岁），其中 111 名（21.7%）在 3-4 个月时进行了随访。初次就诊时有 4%的患者报告月经模式发生变化，随访时有 10.8%的患者报告月经模式发生变化。在 3-4 个月时，损伤时的月经阶段与月经周期变化无关（P=0.40），但与 PCSI 上脑震荡症状的发生相关（P=0.01）。
在脑震荡后 3-4 个月，10 名青少年中有 1 名出现月经变化。损伤时的月经周期阶段与脑震荡后症状的发生相关。利用大量的脑震荡后月经模式样本，本研究代表了女性青少年脑震荡潜在月经周期影响的基础数据。
