Menstrual phase as predictor of outcome after mild traumatic brain injury in women.
OBJECTIVE
To determine whether menstrual cycle phase in women at the time of mild traumatic brain injury (mTBI) predicts 1-month outcomes.


METHODS
Six emergency departments; 5 in Upstate New York, and 1 in Pennsylvania.


METHODS
One hundred forty-four female participants (age, 16-60) who presented to participating emergency departments within 4 hours of mTBI.


METHODS
Nested cohort study with neurologic and quality-of-life outcome assessment, 1 month after enrollment. Female subjects aged 16 to 60 enrolled in the parent cohort study, with 1-month neurological determination data available, were classified into menstrual cycle groups by serum progesterone concentration and self-reported contraceptive use.


METHODS
Rivermead Post Concussion Questionnaire and EuroQoL/EQ5D.


RESULTS
Women injured during the luteal phase of their menstrual cycle, when progesterone concentration is high, had significantly lower EuroQoL General Health Ratings and Index Scores than women injured during the follicular phase of their cycle or women taking oral contraceptives. Multivariate analysis confirmed a significant independent effect of menstrual cycle phase on EuroQoL Index Score and the Rivermead Post Concussion Questionnaire Somatic Subscore.


CONCLUSIONS
Menstrual cycle phase and progesterone concentration at the time of mTBI affect 1-month quality-of-life and neurologic outcomes. This association has important implications for treatment and prognosis after mTBI.
(Ms Wunderle); Department of Obstetrics and Gynecology, (Dr Hoeger); Division of Epidemiology, Department of Public Health Sciences, (Ms Wasserman); Department of Emergency Medicine, University of Rochester School of Medicine and Dentistry, Rochester, New York (Dr Bazarian).
Kathryn
K
Wunderle
Kathleen M
KM
Hoeger
Erin
E
Wasserman
Jeffrey J
JJ
Bazarian
D000293:Adolescent; D000328:Adult; D001930:Brain Injuries / Q000453:epidemiology*; D015331:Cohort Studies; D003278:Contraceptives, Oral, Hormonal; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008597:Menstrual Cycle; D008875:Middle Aged; D015999:Multivariate Analysis; D063868:Patient Outcome Assessment; D011374:Progesterone / Q000097:blood; D011788:Quality of Life; D055815:Young Adult
D003278:Contraceptives, Oral, Hormonal; D011374:Progesterone