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Prenatal Maternal Smoking and Tourette Syndrome: A Nationwide Register Study

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Abstract

This is the first nationwide register-based study to examine the relationship between prenatal maternal smoking and Tourette syndrome. A total of 767 children diagnosed with Tourette syndrome were identified from the Finnish Hospital Discharge Register. Each case was matched to four controls. Information on maternal smoking during pregnancy was obtained from the Finnish Medical Birth Register. Conditional logistic regression models were used for statistical analyses. Prenatal maternal smoking was associated with Tourette syndrome when comorbid with ADHD (OR 4.0, 95 % CI 1.2–13.5, p = 0.027 for exposure during first trimester, OR 1.7, 95 % CI, 1.05–2.7, p = 0.031 for exposure for the whole pregnancy). There was no association between maternal smoking during pregnancy and Tourette syndrome without comorbid ADHD (OR 0.5, 95 % CI 0.2–1.3, p = 0.166, OR 0.9, 95 % CI 0.7–1.3, p = 0.567). Further research is needed to elucidate the mechanisms behind the association between prenatal maternal smoking and Tourette syndrome with comorbid ADHD.

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Abbreviations

TS:

Tourette syndrome

ADHD:

Attention deficit hyperactivity disorder

FHDR:

Finnish Hospital Discharge Register

FMBR:

Finnish Medical Birth Register

ICD:

International Classification of Diseases

DSM-5:

Diagnostic and statistical manual of mental disorders, 5th edition

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Acknowledgments

The study was supported by grants from Tourette Syndrome Association (USA), Finnish Brain Foundation (Finland) and the Sigrid Juselius Foundation (Finland). We thank our collegues at the Research Center for Child Psychiatry at University of Turku, especially Juha-Pekka Virtanen who was responsible for data management. We thank the Tourette Syndrome Association, Finnish Brain Foundation and the Sigrid Juselius Foundation for financial support.

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Authors and Affiliations

  1. Department of Child Psychiatry, University of Turku, Turku, Finland

    Susanna Leivonen, Roshan Chudal, Petteri Joelsson, Auli Suominen, Mika Gissler & Andre Sourander

  2. Child Neurology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland

    Susanna Leivonen & Arja Voutilainen

  3. Department of Pediatrics, Turku University Hospital and University of Turku, Turku, Finland

    Mikael Ekblad

  4. Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York State Psychiatric Institute, New York, NY, USA

    Alan S. Brown

  5. Department of Epidemiology, Columbia University, Mailman School of Public Health, New York, NY, USA

    Alan S. Brown

  6. National Institute of Health and Welfare (THL), Helsinki, Finland

    Mika Gissler

  7. Nordic School of Public Health, Gothenburg, Sweden

    Mika Gissler

  8. Department of Child Psychiatry, Turku University Hospital, Turku, Finland

    Andre Sourander

  9. RKBU, UiT Arctic University in Norway, Tromsø, Norway

    Andre Sourander

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  1. Susanna Leivonen
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  2. Roshan Chudal
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Correspondence to Susanna Leivonen.

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Leivonen, S., Chudal, R., Joelsson, P. et al. Prenatal Maternal Smoking and Tourette Syndrome: A Nationwide Register Study. Child Psychiatry Hum Dev 47, 75–82 (2016). https://doi.org/10.1007/s10578-015-0545-z

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