Objective：Tourettes Syndrome(TS) is a childhood onset movement disorder hat is characterized by a chronic waxing and waning severity of motor and phonic tics. Increased rates of pre- and perinatal complications in TS subjects have been reported. This case-control study examined three hypotheses. Compared to normal controls, TS subjects will have a higher rate of exposure to 1) hypoxic perinatal risk factors such as prolonged labor(≥20 hours) in duration, and 2) severe maternal nausea and vomiting during the first trimester. Furthermore, 3) the presence of these perinatal risk factors will predict a more severe tic severity outcome in TS subjects. Method：Twenty four TS subjects who were born in 8 consecutive months of 1975 and referred to the Yale Child Study Center for the evaluation of TS, and 29 matched community controls were recruited. Subjects were interviewed inperson with Modified Schedule for Risk and Protective Factors in Early Development. Logistic regression and correlation analyses were performed. Results：The rates of prolonged labor and severe nausea and vomiting during first trimester were significantly elevated in TS subjects. Prolonged labor and forceps delivery were positively associated with worst ever tic severity. Conclusions：These findings support the importance of the role of perinatal risk factors including prolonged labor, severe hyperemesis during the first trimester, and forceps delivery in the pathogenesis of TS and expression of tic severity.
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