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An investigation of the pre-injury risk factors associated with children who experience traumatic brain injury
  1. A McKinlay1,
  2. E G E Kyonka1,2,
  3. R C Grace1,
  4. L J Horwood3,
  5. D M Fergusson3,
  6. M R MacFarlane4
  1. 1Department of Psychology, University of Canterbury, Christchurch, New Zealand
  2. 2West Virginia University, Morgantown, West Virginia, USA
  3. 3Christchurch Health and Development Study, University of Otago, Christchurch, New Zealand
  4. 4Department of Neurosurgery, Christchurch Hospital, Christchurch, New Zealand
  1. Correspondence to Dr A McKinlay, Department of Psychology, University of Canterbury, Private Bag 4800, Christchurch, New Zealand; audrey.mckinlay{at}


Background and 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, ≥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.

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  • Funding The Christchurch Health and Development Study has been funded by grants from the Health Research Council of New Zealand, the National Child Health Research Foundation, the Canterbury Medical Research Foundation, and the New Zealand Lottery Grants Board. This research was funded by grants from the Canterbury Medical Research Foundation and the New Zealand Lottery Grants Board. The research was conducted during tenure of an ACC Post-Doctoral Research Career Development Award from the Health Research Council of New Zealand and the Accident Compensation Corporation.

  • Competing interests None.

  • Ethics approval Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.