Do pregnant women have improved outcomes after traumatic brain injury?

BACKGROUND: Pregnant women, who have significantly elevated levels of estrogen and progesterone, might benefit from the neuroprotective effect of steroid hormones. METHODS: Pregnant patients were identified and compared with their nonpregnant counterparts with respect to demographics and outcome. \ RESULTS: Of the 18,800 female, moderate to severe TBI patients, 71 were pregnant. Similar mortalities were noted in pregnant and nonpregnant TBI patients (9.9% vs 9.3%, P = .84). Adjusting for confounding variables, pregnant TBI patients had a trend toward increased mortality (adjusted odds ratio [AOR] = 2.2; 95% confidence interval [CI], .9-5.1; P = .07). In patients aged 15 to 47 years (n = 8,854), similar mortalities were noted in pregnant and nonpregnant TBI patients (9.9% vs 6.8%, P = .34). After adjusting for risk factors, again there was a trend toward increased mortality in the pregnant TBI group (AOR = 2.0; 95% CI, .8-4.6; P = .12). CONCLUSIONS: Pregnant patients with moderate to severe TBI show no statistically significant difference in mortality compared with their nonpregnant counterparts. (C) 2011 Elsevier Inc. All rights reserved.