title: Obstetric and Neonatal Adversities, Parity, and Tourette Syndrome: A Nationwide Registry.
abstract: OBJECTIVE
  To determine the relationships between parity, obstetric adversities, neonatal factors, and Tourette syndrome in a large nationwide cohort.
  
  
  METHODS
  This nationwide, register-based, nested case-control study identified all children diagnosed with Tourette syndrome born between 1991 and 2010 from the Finnish Hospital Discharge Register (n = 767). Each case was matched to 4 controls. Information on parity, obstetric, and neonatal factors was obtained from the Finnish Medical Birth Register. Conditional logistic regression was used to determine the relationship between parity, obstetric, and neonatal factors, and Tourette syndrome.
  
  
  RESULTS
  Nulliparity was associated with increased odds for Tourette syndrome (OR 1.7, 95% CI 1.4-2.2), and 3 or more previous births was associated with decreased odds for Tourette syndrome (OR 0.5, 95% CI 0.3-0.9) compared with parity 1-2. Birth weight 4000-4499 g was associated with decreased odds for Tourette syndrome (OR 0.7, 95% CI 0.5-0.9). Low birth weight, gestational age, weight for gestational age, Apgar score at 1 minute, induced labor, birth type or presentation, neonatal treatment, or maternal blood pressure were not associated with Tourette syndrome.
  
  
  CONCLUSIONS
  Increasing parity and high birth weight are associated with decreased odds for Tourette syndrome.
authors.affiliation: Department of Child Psychiatry, University of Turku, Turku, Finland; Child Neurology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland. Electronic address: susanna.leivonen@utu.fi.
authors.forename: Susanna
authors.initials: S
authors.lastname: Leivonen
authors.affiliation: Child Neurology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
authors.forename: Arja
authors.initials: A
authors.lastname: Voutilainen
authors.affiliation: Department of Child Psychiatry, University of Turku, Turku, Finland.
authors.forename: Roshan
authors.initials: R
authors.lastname: Chudal
authors.affiliation: Department of Child Psychiatry, University of Turku, Turku, Finland.
authors.forename: Auli
authors.initials: A
authors.lastname: Suominen
authors.affiliation: National Institute of Health and Welfare (THL), Helsinki, Finland; Nordic School of Public Health, Gothenburg, Sweden.
authors.forename: Mika
authors.initials: M
authors.lastname: Gissler
authors.affiliation: Department of Child Psychiatry, University of Turku, Turku, Finland; Department of Child Psychiatry, Turku University Hospital, Turku, Finland; Regional Centre for Child and Youth Mental Health and Child Welfare, UiT The Arctic University of Norway, Tromsø, Norway.
authors.forename: Andre
authors.initials: A
authors.lastname: Sourander
mesh_terms: D000328:Adult; D001724:Birth Weight; D001794:Blood Pressure; D016022:Case-Control Studies; D015331:Cohort Studies; D005260:Female; D005387:Finland; D005865:Gestational Age; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D008423:Maternal Age; D016017:Odds Ratio; D010298:Parity; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis / Q000453:epidemiology*; D012042:Registries; D012044:Regression Analysis; D005879:Tourette Syndrome / Q000175:diagnosis / Q000453:epidemiology*; D055815:Young Adult