An investigation of the pre-injury risk factors associated with children who experience traumatic brain injury.
OBJECTIVE
Traumatic brain injury (TBI) is a frequently occurring event in childhood that may have significant ongoing effects. Little is known about the child and family characteristics that predispose children to these injuries. A greater understanding of the risk factors associated with childhood TBI may provide an opportunity to prevent their occurrence.


METHODS
Information provided by a large birth cohort study (n=1265) was used to determine the child and family risk factors of TBI in children aged 0-15 years (n=187). All information regarding child, family, and injury events were collected prospectively and unrelated to the injury event itself. Child variables included in the analysis were sex and the level of behavioural problems. Parental variables included were family socioeconomic status, mother's age, education level, depressive symptoms, number of adverse life events experienced by the family, and parenting style.


RESULTS
The most important risk factors were sex, adverse life events, and parenting style. The results suggest evidence of modest increases in the rate of TBI for those in the highest risk categories (male, >or=4 life events per annum, high maternal punitiveness) compared to the lowest risk categories, with hazard ratios in the region of 1.4-1.6.


CONCLUSIONS
Overall characteristics of both the family and child predicted a TBI event. An increased understanding of risks associated with TBI in childhood will provide an avenue to prevent these injuries by targeting at-risk families and aiding the development of appropriate intervention strategies.
McKinlay
A
A
Department of Psychology, University of Canterbury, Christchurch, New Zealand. audrey.mckinlay@canterbury.ac.nz
Kyonka
E G E
EG
Grace
R C
RC
Horwood
L J
LJ
Fergusson
D M
DM
MacFarlane
M R
MR
D000293:Adolescent; D000328:Adult; D001930:Brain Injuries / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D002648:Child; D002653:Child Behavior Disorders / Q000150:complications / Q000453:epidemiology; D016241:Child of Impaired Parents; D002675:Child, Preschool; D003863:Depression / Q000453:epidemiology; D004812:Epidemiologic Methods; D005191:Family Characteristics; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008423:Maternal Age; D009520:New Zealand / Q000453:epidemiology; D016487:Parenting; D012737:Sex Factors; D012959:Socioeconomic Factors; D055815:Young Adult