目的：现有研究，在大多数男性样本中，如退伍军人和运动员，显示创伤性脑损伤（TBI）和精神疾病之间有很强的关联。然而，虽然了解怀孕前的心理健康对于告知孕前和围产期支持至关重要，没有关于TBI女性怀孕前活动性精神疾病患病率的数据。我们检查了TBI人群中妊娠前≤2年的活动性精神疾病的患病率（1），和(2)在由社会人口统计学定义的亚组中，健康,和伤害相关的特征，与没有TBI的人相比。
方法：这项基于人群的横断面研究在安大略省完成，加拿大,从2012年到2020年。改良的Poisson回归产生了15,585例TBI女性与846,686例无TBI女性的妊娠前≤2年活动性精神疾病的调整患病率比（aPRs）。然后，我们根据社会人口统计学使用潜在类别分析来识别患有TBI的亚组，健康,和损伤相关特征，随后将它们与没有TBI的女性的结局患病率进行比较。
结果：患有TBI的女性在怀孕前≤2年的活动性精神疾病患病率高于没有TBI的女性（44.1%vs.25.9%；aPR1.46，95%置信区间，1.43至1.49）。有3个TBI亚组,与1级(低收入，过去的攻击，最近的TBI被描述为故意的，并且由于受到/反对）具有最高的结果患病率。
结论：女性患有TBI，尤其是那些最近有故意TBI的人，怀孕前精神病患病率很高。他们可能会从受伤后的心理健康筛查和支持中受益，先入为主,和围产期。
患有创伤性脑损伤的人群在怀孕前2年内患有精神疾病。语言摘要研究表明，创伤性脑损伤（TBI）与精神疾病之间有很强的关联。以前的大多数研究主要是在男性样本中进行的，比如退伍军人和职业运动员。怀孕前了解心理健康对于决定人们在怀孕前和怀孕期间需要什么支持很重要。然而,没有关于怀孕前TBI女性精神疾病频率的研究。我们检查了妊娠前2年患有TBI的人群中精神疾病的频率，在由不同社会定义的子群体中，健康,和伤害相关的特征，与没有TBI的人相比。我们在安大略省对所有有和没有TBI的女性进行了一项全人群研究，加拿大,出生在2012-2020年。我们使用统计模型来比较这些群体在怀孕前2年内是否存在精神疾病，在考虑社会和健康特征之前和之后。我们还根据他们的社会识别了患有TBI的亚组(例如，贫困)，健康(例如，慢性疾病)，和伤害相关特征(例如，受伤原因），随后将其与没有TBI的女性在怀孕前2年内患精神疾病的频率进行比较。患有TBI的女性中有44％在怀孕前2年内患有精神疾病，而没有TBI的女性中有25％患有精神疾病。有3个TBI亚组。低收入女性，过去的攻击，和被描述为故意的伤害在怀孕前2年内发生精神疾病的频率最高。患有TBI的女性可能会从心理健康筛查中受益，并在受伤后和怀孕前后提供支持。
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.
METHODS: 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.
UNASSIGNED: Mental illness in the 2 years before pregnancy in a population with traumatic brain injury.
Research has shown a strong association between traumatic brain injury (TBI) and mental illness. Most previous studies have been conducted in primarily male samples, like veterans and professional athletes. Understanding mental health before pregnancy is important for deciding what supports people need before and during pregnancy. However, there are no studies on the frequency of mental illness in females with TBI before a pregnancy. We examined the frequency of mental illness 2 years before pregnancy in a population with TBI, and in subgroups defined by different social, health, and injury-related characteristics, compared to those without TBI. We undertook a population-wide study of all females with and without TBI in Ontario, Canada, with a birth in 2012–2020. We used statistical models to compare these groups on the presence of mental illness in the 2 years before pregnancy, before and after accounting for social and health characteristics. We also identified subgroups with TBI according to their social (e.g., poverty), health (e.g., chronic conditions), and injury-related characteristics (e.g., cause of injury) and subsequently compared them to females without TBI on their frequency of mental illness in the 2 years before pregnancy. Forty-four percent of females with TBI had mental illness in the 2 years before pregnancy compared to 25% of those without TBI. There were 3 TBI subgroups. Females with low-income, past assault, and injuries that were described as being intentional had the highest frequency of mental illness in the 2 years before pregnancy. Females with TBI may benefit from mental health screening and support post-injury and around the time of pregnancy.
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