Risk factors for children with tic disorder: a systematic review_Chinese Journal of Evidence-Based Medicine

Authors：

LU Chen ¹ , HAO Hongwen ² , LIAO Xinting ¹ , WANG Baosheng ¹ , LI Panpan ¹ ,  WU Liqun ²

1. Beijing University of Chinese Medicine, Beijing 100029, P.R.China;
2. Department of Pediatrics, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing 100078, P.R.China;

Corresponding?author：

WU Liqun, Email: wulq1211@163.com

Keywords：

Tic disorder; Risk factor; Pediatrics; Systematic review; Meta-analysis

DOI：

10.7507/1672-2531.202109158

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Objective To systematically review the risk factors of tic disorder (TD) in children. Methods Databases including PubMed, EMbase, The Cochrane Library, Web of Science, CNKI, CBM, VIP, and WanFang Data were electronically searched to collect observational studies on children with TD from inception to June 29^th 2021. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of the included studies. Meta-analysis was then performed using RevMan 5.3 software. Results A total of 32 studies involving 556 560 children were included. The results of meta-analysis showed that the risk factors for TD were as follows: male (OR=2.23, 95%CI 1.08 to 4.61, P=0.03), premature delivery (OR=1.66, 95%CI 1.04 to 2.64, P=0.03), low birth weight (OR=1.27, 95%CI 1.07 to 1.50, P=0.005), history of neonatal jaundice (OR=7.46, 95%CI 1.15 to 48.42, P=0.04), other adverse factors in the perinatal period (OR=2.74, 95%CI 1.89 to 3.98, P<0.000 01), poor eating habits (OR=2.11, 95%CI 1.52 to 2.93, P<0.000 01), long-term viewing of electronic products (OR=2.22, 95%CI 1.31 to 3.75, P=0.003), history of febrile convulsions (OR=2.43, 95%CI 1.21 to 4.86, P=0.01), recurrent respiratory infection (OR=2.63, 95%CI 1.49 to 4.64, P=0.000 8), chronic tonsillitis (OR=2.01, 95%CI 1.31 to 3.09, P=0.001), rhinopathy (OR=1.77, 95%CI 1.35 to 2.31, P<0.000 1), attention deficit hyperactivity disorder (ADHD) (OR=5.32, 95%CI 3.77 to 7.51, P<0.000 01), decreased blood iron content (OR=3.68, 95%CI 1.56 to 8.67, P=0.003), family history of TD (OR=6.33, 95%CI 3.20 to 12.53, P<0.000 01), family history of mental illness (OR=2.39, 95%CI 2.03 to 2.83, P<0.000 01), maternal mental disorder during pregnancy (OR=2.49, 95%CI 1.99 to 3.11, P<0.000 01), alcohol drinking during pregnancy (OR=1.40, 95%CI 1.09 to1.79, P=0.007), smoking or passive smoking during pregnancy (OR=1.84, 95%CI 1.68 to 2.01, P<0.000 01), and corporal punishment (OR=3.57, 95%CI 1.52 to 8.34, P=0.003). Parity (second birth and above) (OR=0.41, 95%CI 0.25 to 0.68, P=0.000 6) was a protective factor for tic disorder. Conclusions Current evidence shows that the incidence of TD is related to gender, family history of mental illness, maternal life habits during pregnancy, perinatal history, chronic respiratory diseases, abnormal trace elements, and strict education methods, etc. Moreover, parity is a protective factor for the occurrence of TD. Due to the limited quantity and quality of included studies, more high-quality studies are required to verify the above conclusions.

Citation： LU Chen, HAO Hongwen, LIAO Xinting, WANG Baosheng, LI Panpan, WU Liqun. Risk factors for children with tic disorder: a systematic review. Chinese Journal of Evidence-Based Medicine, 2021, 21(12): 1407-1415. doi: 10.7507/1672-2531.202109158 Copy

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1. 劉茂昌, 劉智勝. 兒童抽動障礙藥物治療研究現狀. 中華實用兒科臨床雜志, 2020, 35(12): 948-951.
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3. Li F, Cui Y, Li Y, et al. Prevalence of mental disorders in school children and adolescents in China: diagnostic data from detailed clinical assessments of 17 524 individuals. J Child Psychol Psychiatry, 2021. DOI: 10.1111/jcpp.13445.
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5. 曾憲濤, 劉慧, 陳曦, 等. Meta分析系列之四: 觀察性研究的質量評價工具. 中國循證心血管醫學雜志, 2012, 4(4): 297-299.
6. 孫中運, 衣明紀, 冉霓, 等. Tourette綜合征發病危險因素的病例對照研究. 臨床兒科雜志, 2011, 29(12): 1162-1166.
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9. 李樹華, 龐保東, 徐應軍, 等. 抽動-穢語綜合征危險因素的病例對照研究. 中國兒童保健雜志, 2004, 12(5): 412-414.
10. 楊春松, 張伶俐, 俞丹, 等. 孕期危險因素與兒童抽動障礙關系的配對病例對照研究. 國際精神病學雜志, 2018, 45(5): 867-870.
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13. 高翠琴. 鏈球菌感染及家庭因素與小兒抽動障礙的關系. 廣西醫學, 2017, 39(5): 615-617.
14. 黃天然, 陸燕珍, 岑麗婷, 等. 肇慶市100例兒童抽動障礙發病危險因素分析. 中外醫學研究, 2021, 19(6): 172-174.
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17. 阮洋, 莫麗亞, 張聰, 等. 兒童抽動癥與微量元素水平的相關性研究. 國際檢驗醫學雜志, 2014, (19): 2691-2692.
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23. Cubo E, Hortigüela M, Jorge-Roldan S, et al. Prenatal and perinatal morbidity in children with tic disorders: a mainstream school-based population study in central Spain. Tremor Other Hyperkinet Mov, 2014, 4: 272.
24. Ben-Shlomo Y, Scharf JM, Miller LL, et al. Parental mood during pregnancy and post-natally is associated with offspring risk of Tourette syndrome or chronic tics: prospective data from the Avon Longitudinal Study of Parents and Children (ALSPAC). Eur Child Adolesc Psychiatry, 2016, 25(4): 373-381.
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26. Zhu P, Wu M, Huang P, et al. Children from nuclear families with bad parental relationship could develop tic symptoms. Mol Genet Genomic Med, 2020, 8(7): e1286.
27. Mataix-Cols D, Isomura K, Pérez-Vigil A, et al. Familial risks of Tourette syndrome and chronic tic disorders: a population-based cohort study. JAMA Psychiatry, 2015, 72(8): 787-793.
28. Hesapçıoğlu ST, Tural MK, Kandil S. Sociodemographic/clinical characteristics and risk factors associated with chronic tic disorders. Turk Psikiyatri Derg, 2013, 24(3): 158-167.
29. Whitaker AH, Feldman JF, Lorenz JM, et al. Neonatal head ultrasound abnormalities in preterm infants and adolescent psychiatric disorders. Arch Gen Psychiatry, 2011, 68(7): 742-752.
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Chinese Journal of Evidence-Based Medicine

Risk factors for children with tic disorder: a systematic review

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