The Impact of Female Reproductive Function on Outcomes After Traumatic Brain Injury

Abstract

Ripley DL, Harrison-Felix C, Sendroy-Terrill M, Cusick CP, Dannels-McClure A, Morey C. The impact of female reproductive function on outcomes after traumatic brain injury. Objectives To determine the impact of traumatic brain injury (TBI) on female menstrual and reproductive functioning and to examine the relationships between severity of injury, duration of amenorrhea, and TBI outcomes. Design Retrospective cohort survey. Setting Telephone interview. Participants Women (N=30; age range, 18–45y), between 1 and 3 years postinjury, who had completed inpatient rehabilitation for TBI. Interventions Not applicable. Main Outcome Measures Data collected included menstrual and reproductive functioning pre- and postinjury, demographic, and injury characteristics. Outcome measures included the Glasgow Outcome Scale–Extended (GOS-E), the Mayo-Portland Adaptability Inventory–4 (MPAI-4), and the Medical Outcome Study 12-Item Short-Form Health Survey, Version 2 (SF-12v2). Results The median duration of amenorrhea was 61 days (range, 20–344d). Many subjects' menstrual function changed after TBI, reporting a significant increase in skipped menses postinjury ( P<.001) and a trend toward more painful menses ( P=.061). More severe TBI, as measured by the duration of posttraumatic amnesia, was significantly predictive of a longer duration of amenorrhea ( P=.004). Subjects with a shorter duration of amenorrhea scored significantly better on the SF-12 physical component subscale ( P=.004), the GOS-E ( P=.05), and the MPAI-4 participation subscale ( P=.05) after controlling for age, injury severity, and time postinjury. Conclusions The severity of TBI was predictive of duration of amenorrhea and a shorter duration of amenorrhea was predictive of better ratings of global outcome, community participation, and health-related quality of life postinjury.