Pregnancy, Fetal, and Neonatal Outcomes Among Women With Traumatic Brain Injury.
Rachel Sayko Adams, Ilhom Akobirshoev, Lisa A Brenner and 2 others
PMID 36731040WHAT IT FOUND
Women with a traumatic brain injury diagnosis during delivery had more than double the risk of placental abruption and stillbirth compared to those without.
These risks persisted after adjusting for other health conditions, suggesting a need for closer monitoring.
Key findings
01Women with TBI had significantly increased risk for placental abruption, antepartum hemorrhage, and cesarean delivery.
02Women with TBI were at increased risk for stillbirth and having a neonate large for gestational age.
03These associations persisted after controlling for clinical characteristics such as psychiatric and substance use disorders.
STILL TO COME
How it was doneWhat they found
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What it does not show
The study relies on administrative claims data, meaning TBI diagnoses may be under-recorded, especially for mild injuries, leading to conservative estimates. The data does not specify the mechanism of injury (e.g., falls, violence, car accidents) or the severity of the TBI. The timing of the TBI relative to the pregnancy is unknown; it could have occurred during pregnancy or years prior. The analysis is at the delivery level, not the person level, so a single woman with multiple deliveries could be counted more than once. The study cannot prove causation, only association, as it is cross-sectional in nature regarding the TBI history.
Declared interests
The study used existing, de-identified secondary data from the Nationwide Inpatient Sample, sponsored by the Agency for Healthcare Research and Quality. No specific funding sources or author conflicts of interest were detailed in the provided text beyond the general support for the database.
The easy way to misread this
Do not assume the TBI itself is the sole cause of these risks. The study cannot determine if the adverse outcomes were caused by the brain injury, the physical trauma that caused the injury (such as intimate partner violence or car accidents), or the higher rates of comorbidities like diabetes and substance use seen in this group.