创伤性脑损伤患者妊娠前 2 年的精神疾病：一项横断面研究
Mental Illness in the 2 Years Prior to Pregnancy in a Population With Traumatic Brain Injury: A Cross-Sectional Study: La maladie mentale dans les deux ans précédant une grossesse dans une population souffrant de lésion cérébrale traumatique : une étude transversale.
机构信息
Department of Health & Society, University of Toronto Scarborough, Toronto, ON, Canada.
Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
出版信息
Can J Psychiatry. 2024 Aug;69(8):607-617. doi: 10.1177/07067437241249957. Epub 2024 Apr 25.
OBJECTIVE
Existing studies, in mostly male samples such as veterans and athletes, show a strong association between traumatic brain injury (TBI) and mental illness. Yet, while an understanding of mental health before pregnancy is critical for informing preconception and perinatal supports, there are no data on the prevalence of active mental illness before pregnancy in females with TBI. We examined the prevalence of active mental illness ≤2 years before pregnancy (1) in a population with TBI, and (2) in subgroups defined by sociodemographic, health, and injury-related characteristics, all compared to those without TBI.
METHOD
This population-based cross-sectional study was completed in Ontario, Canada, from 2012 to 2020. Modified Poisson regression generated adjusted prevalence ratios (aPRs) of active mental illness ≤2 years before pregnancy in 15,585 females with TBI versus 846,686 without TBI. We then used latent class analysis to identify subgroups with TBI according to sociodemographic, health, and injury-related characteristics and subsequently compared them to females without TBI on their outcome prevalence.
RESULTS
Females with TBI had a higher prevalence of active mental illness ≤2 years before pregnancy than those without TBI (44.1% vs. 25.9%; aPR 1.46, 95% confidence interval, 1.43 to 1.49). There were 3 TBI subgroups, with Class 1 (low-income, past assault, recent TBI described as intentional and due to being struck by/against) having the highest outcome prevalence.
CONCLUSIONS
Females with TBI, and especially those with a recent intentional TBI, have a high prevalence of mental illness before pregnancy. They may benefit from mental health screening and support in the post-injury, preconception, and perinatal periods.
PLAIN LANGUAGE TITLE
Mental illness in the 2 years before pregnancy in a population with traumatic brain injury.
目的
现有的研究主要集中在退伍军人和运动员等男性样本中，这些研究表明创伤性脑损伤（TBI）与精神疾病之间存在很强的关联。然而，尽管了解怀孕前的心理健康状况对于提供孕前和围产期支持至关重要，但目前还没有关于 TBI 女性在怀孕前患有活跃精神疾病的患病率数据。我们研究了（1）TBI 人群中，以及（2）按社会人口统计学、健康和损伤相关特征定义的亚组中，在怀孕前 2 年内患有活跃精神疾病的患病率，所有这些都与没有 TBI 的人群进行了比较。
方法
这是一项基于人群的横断面研究，于 2012 年至 2020 年在加拿大安大略省进行。采用修正泊松回归生成了怀孕前 2 年内患有活跃精神疾病的 TBI 女性与没有 TBI 的女性的调整后患病率比（aPR）。然后，我们使用潜在类别分析根据社会人口统计学、健康和损伤相关特征确定 TBI 亚组，并随后比较这些亚组与没有 TBI 的女性在结局患病率方面的差异。
结果
与没有 TBI 的女性相比，TBI 女性在怀孕前 2 年内患有活跃精神疾病的比例更高（44.1% vs. 25.9%；aPR 1.46，95%置信区间为 1.43 至 1.49）。TBI 有 3 个亚组，其中亚组 1（低收入、过去遭受袭击、最近的 TBI 描述为故意的，因被撞击/打击所致）的结局患病率最高。
结论
患有 TBI 的女性，尤其是那些最近因故意 TBI 而患有 TBI 的女性，在怀孕前患有精神疾病的比例较高。她们可能受益于受伤后、怀孕前和围产期的心理健康筛查和支持。
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