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 prcdant une grossesse dans une population souffrant de lsion crbrale traumatique : une tude transversale

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. Mental illness in the 2 years before pregnancy in a population with traumatic brain injuryPlain Language SummaryResearch 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. Objectif Il existe des & eacute;tudes, r & eacute;alis & eacute;es aupr & egrave;s d'& eacute;chantillons surtout masculins, comme des anciens combattants et des athl & egrave;tes, montrant une forte association entre la l & eacute;sion c & eacute;r & eacute;brale traumatique (LCT) et la maladie mentale. Et pourtant, bien que la compr & eacute;hension de la sant & eacute; mentale avant la grossesse soit essentielle pour informer les soutiens pr & eacute;conceptionnels et p & eacute;rinataux, il n'y a pas de donn & eacute;es sur la pr & eacute;valence de la maladie mentale active avant la grossesse chez les femmes souffrant de LCT. Nous avons examin & eacute; la pr & eacute;valence de la maladie mentale active <= 2 ans avant la grossesse (1) dans une population souffrant de LCT, et (2) dans des sous-groupes d & eacute;finis par des caract & eacute;ristiques sociod & eacute;mographiques, de sant & eacute;, et li & eacute;es & agrave; la l & eacute;sion, tous se comparaient & agrave; ceux sans LCT.M & eacute;thode Cette & eacute;tude transversale dans la population a & eacute;t & eacute; men & eacute;e en Ontario, Canada, de 2012 & agrave; 2020. La r & eacute;gression de Poisson modifi & eacute;e a g & eacute;n & eacute;r & eacute; des ratios de pr & eacute;valence ajust & eacute;s (RPa) de maladie mentale active <= 2 ans avant la grossesse chez 15 585 femmes souffrant de LCT contre 846 686 sans LCT. Nous avons ensuite utilis & eacute; l'analyse des classes latentes pour identifier des sous-groupes souffrant de LCT selon nos caract & eacute;ristiques sociod & eacute;mographiques, de sant & eacute; et li & eacute;es & agrave; la l & eacute;sion, et les avons subs & eacute;quemment compar & eacute;s aux femmes sans LCT quant & agrave; leur pr & eacute;valence des r & eacute;sultats.R & eacute;sultats Les femmes souffrant de LCT avaient une pr & eacute;valence plus & eacute;lev & eacute;e de maladie mentale active <= 2 ans avant la grossesse que celles sans LCT (44,1% c. 25,9%; RPa 1,46, 95% IC 1,43 & agrave; 1,49). Il y avait 3 sous-groupes LCT, la classe 1 ((faible revenu, agression pass & eacute;e, TBI r & eacute;cent d & eacute;crit comme intentionnel et d & ucirc; & agrave; une collision) ayant la pr & eacute;valence de r & eacute;sultats la plus & eacute;lev & eacute;e.Conclusions Les femmes souffrant de LCT, et sen particuoier celles ayant une LCT intentionnelle r & eacute;cente, ont une pr & eacute;valence & eacute;lev & eacute;e de maladie mentale avant la grossesse.Elles peuvent b & eacute;n & eacute;ficier d'un d & eacute;pistage de maladie mentale et d'un soutien dans les p & eacute;riodes post-traumatique, pr & eacute;conceptionnelle et p & eacute;rinatale.