Prenatal and Perinatal Morbidity in Children with Tic Disorders: A Mainstream School-based Population Study in Central Spain

Esther Cubo; Montesclaros Hortigüela; Sandra Jorge-Roldan; Selva Esther Ciciliani; Patricia Lopez; Leticia Velasco; Emilio Sastre; Vanesa Ausin; Vanesa Delgado; Sara Saez; José Trejo Gabriel-Galán; Jesús Macarrón

doi:10.5334/tohm.200

Figures & Tables

Table 1

Clinical Characteristics Comparison

	Comparison of Tics		p-Value
	No	Yes
	N = 89	N = 64
Child characteristics
Gender (male %)	57 (64)	45 (70)	0.41
Age (mean ± SD)	11.81 ± 3.03	10.78 ± 2.84	0.04
Handedness (%)
Right handed	80 (91)	55 (87)	0.01
Left handed	4 (5)	4 (6)
Ambidextrous	4 (5)	4 (6)
Body mass index	18.85 ± 2.89	17.56 ± 0.01	0.01
IQ mean ± SD	100.65 ± 11.48	99.91 ± 10.56	0.68
ADHD (%)	9 (10)	10 (16)	1.00
OCD (%)	3 (3)	2 (3)	0.37
Other medical conditions (%)	12 (14)	8 (13)	0.37
Family history
Tics (%)	17 (19)	22 (35)	0.03
ADHD (%)	1 (3)	1 (3)	1.00
OCD (%)	1 (3)	0 (0)	1.00
Parental education background
Primary and secondary studies (%)
Father	64 (74)	41 (69)	0.95
College and higher studies (%)
Father	22 (26)	19 (31)
Primary and secondary studies (%)
Mother	63 (81)	43 (77)	0.99
College and higher studies (%)
Mother	25 (29)	21 (23)
Pre-perinatal neonatal risk factors
Mother's age (mean ± SD)	30.67 ± 4.42	30.05 ± 4.88	0.37
Healthy mother before pregnancy (%)	75 (88)	48 (76)	0.05
Prenatal smoking exposure (%)	21 (25)	25 (40)	0.05
Prenatal alcohol exposure (%)	0 (0)	1 (1)	0.42
Normal pregnancy (%)	58(79)	38 (70)	0.23
Prenatal infection (%)	2 (2)	7 (11)	0.03
Eclampsia (%)	0 (0)	1 (2)	0.42
Gestational diabetes (%)	11 (15)	3 (6)	0.09
Gestational age (mean ± SD) weeks	39.27 ± 1.38	38.89 ± 1.58	0.12
Twin birth (%)	2 (3)	3 (5)	0.64
Vaginal delivery presentation (%)
Vertex	66 (90)	46 (87)	0.21
Transverse	5 (7)	2 (4)
Breech	2 (3)	5 (9)
Cesarean section (%)	8 (9)	23 (37)	<0.0001
Cause of cesarean section (%)
Unknown	1 (13)	1 (4)	0.31
Cephalopelvic disproportion	0 (0)	3 (13)
At risk for NRDS	3 (38)	10 (43)
Planned	4 (50)	5 (22)
Prolonged second stage	0 (0)	4 (17)
Instrumental vaginal delivery (%)	13 (59)	9 (40)	0.51
Perinatal hypoxia (%)	5 (6)	6 (9)	0.52
Apgar at 1 minute (mean ± SD)	8.65 ± 1.18	8.56 ± 1.01	0.19
Apgar at 5 minutes (mean ± SD)	9.82 ± 0.76	9.76 ± 0.53	0.07
NRDS (%)	11 (12)	14 (25)	0.03
Birth weight (g) mean ± SD	3197 ± 443	3129 ± 473	0.53
Birth length (cm) mean ± SD	50.24± 1.73	49.92± 2.45	0.34
Cephalic perimeter (cm) mean + SD	34.65 ± 1.34	34.8 ± 2.31	0.88
Need for incubator (%)	6 (7)	8 (16)	0.13
Intrauterine growth retardation¹ (%)	6 (7)	5 (8)	1.00
Prematurity² (%)	4 (4)	6 (9)	0.32
Jaundice (%)	9 (10)	4 (6)	0.39
Other significant co-existent medical conditions³ (%)	4 (6)	4 (6)	1.00

Abbreviations: ADHD, Attention Deficit Hyperactivity Disorder; IQ, Intellectual Quotient; NRDS, Neonatal Respiratory Distress Syndrome; OCD, Obsessive Compulsive Disorder; SD, Standard Deviation.

1 Intrauterine growth retardation was determined by taking the birth weight and gestational age of the baby and comparing the value to a population-based Spanish reference for small for gestational age cut-offs (10th percentile).

2 Prematurity was defined as <36-week pregnancy.

3 Other significant medical conditions included heart disorders, transient tachypnea, pneumomediastinum, malformations, and hydronephrosis.

Table 2

Logistic Regression of Model of Tics vs. No Tics (Dependent Variable)

	Adjusted Odds Ratio (95% CI)	p-Value
Cesarean section	5.78 (1.60–20.91)	0.007
Prenatal smoking exposure	3.07 (1.24–7.60)	0.01
Neonatal respiratory syndrome	1.21 (0.325.61)	0.77
Prenatal infection	2.84 (0.40–19.84)	0.29

[i] Abbreviation: CI, Confidence Interval.

[ii] The logistic regression model was adjusted for family history of tics, body mass index, and presence of any coexistent comorbid neuropsychiatric disturbances.

[iii] The model fitness was adequate (Nagelke R², p = 0.28; Hosmer–Lemeshow, p = 0.67). This model classified 73.4% of the population (55.1% with tics and 85.3% without tics).