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Is neonatal jaundice associated with Autism Spectrum Disorders: a systematic review

Sanjiv B Amin1, Tristram Smith, Hongyue Wang

  • 1Division of Neonatology, Department of Pediatrics, The University of Rochester School of Medicine and Dentistry, P.O. Box 651, 601 Elmwood Avenue, Rochester, NY 14642, USA. Sanjiv_amin@urmc.rochester.edu

Journal of Autism and Developmental Disorders
|October 20, 2011
PubMed

Insights

Neonatal jaundice, or unconjugated hyperbilirubinemia, is linked to Autism Spectrum Disorder (ASD) in term infants. Further research is needed for preterm infants, as current measures may not fully capture risks.

Area of Science:

  • Neonatal care
  • Neurodevelopmental disorders
  • Pediatric research

Background:

  • Neonatal jaundice (unconjugated hyperbilirubinemia) is a common condition in newborns.
  • Autism Spectrum Disorder (ASD) is a complex neurodevelopmental condition.
  • The potential link between neonatal jaundice and ASD requires systematic investigation.

Purpose of the Study:

  • To systematically review and meta-analyze existing literature on the association between neonatal jaundice and ASD.
  • To examine this association in both term and preterm infants.
  • To assess the role of bilirubin levels in predicting neurodevelopmental outcomes.

Main Methods:

  • Systematic literature review following MOOSE guidelines.
  • Meta-analysis of 13 observational studies, primarily retrospective matched case-control designs.
  • Assessment of jaundice using total serum bilirubin (TSB) levels.

Main Results:

  • A significant association was found between neonatal jaundice (TSB) and ASD in the overall cohort (OR, 1.43; 95% CI 1.22-1.67).
  • This association was not statistically significant in preterm infants (OR 0.7; 95% CI 0.38-1.02).
  • Significant heterogeneity was noted among the included studies (Q = 31, p = 0.002).

Conclusions:

  • Overall, neonatal jaundice is associated with an increased risk of ASD in term infants.
  • The association between jaundice and ASD in preterm infants requires further investigation, considering alternative bilirubin measures.
  • Unbound unconjugated bilirubin may be a more sensitive indicator of neurotoxicity than TSB in preterm infants.

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