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Associations between neonatal jaundice and autism spectrum disorder or attention deficit hyperactivity disorder:
Hung-Chieh Chou1, Hung-Chih Lin2, Kuang-Hua Huang3
1Department of Pediatrics, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan; Department of Pediatrics, National Taiwan University Hospital, Yun-Lin Branch, Yun-Lin, Taiwan.
Insights
Neonatal jaundice is linked to autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD). These associations persist even after accounting for other factors, highlighting a potential risk in newborns with jaundice.
Area of Science:
- Neonatal care
- Developmental neuroscience
- Pediatric neurology
Background:
- Neonatal jaundice may cause brain damage.
- Autistic spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) are developmental disorders potentially linked to early brain injury.
- The relationship between neonatal jaundice and these disorders requires investigation.
Purpose of the Study:
- To explore the association between neonatal jaundice treated with phototherapy and the incidence of ASD or ADHD.
- To determine if phototherapy intensity influences the risk of ASD or ADHD in jaundiced infants.
Main Methods:
- Retrospective nationwide population cohort study using a Taiwanese database (2004-2010).
- Infants categorized into four groups: no jaundice, jaundice without treatment, simple phototherapy, and intensive phototherapy or blood exchange transfusion (BET).
- Cox proportional hazard models analyzed associations between jaundice treatment groups and outcomes (ASD, ADHD) up to age 7.
Main Results:
- 118,222 infants with neonatal jaundice were analyzed.
- Jaundice was significantly associated with increased cumulative incidences of ASD and ADHD.
- Associations remained significant after adjusting for confounding variables and in subgroups of infants with birth weights ≥2500 grams and males.
Conclusions:
- Neonatal jaundice is correlated with higher risks of ASD and ADHD.
- The association between neonatal jaundice and these developmental disorders is significant in both sexes and infants with birth weights over 2500 grams.
Background/Purpose:
Neonatal jaundice might result brain insults. Both autistic spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) are developmental disorders, which might result from early brain injury at neonatal period. We aimed to explore the association between neonatal jaundice treated with phototherapy and the ASD or ADHD.
Methods:
This retrospective nationwide population cohort study was based on a nationally representative database of Taiwan, and neonates born from 2004 to 2010 were enrolled. All eligible infants were divided into 4 groups, without jaundice, jaundice with no treatment, jaundice with simple phototherapy only and jaundice with intensive phototherapy or blood exchange transfusion (BET). Each infant was follow-up until the date of incident primary outcomes, death, or 7-year-old, whichever occurred first. Primary outcomes were ASD, ADHD. Using cox proportional hazard model to analyze their associations.
Results:
In total, 118,222 infants with neonatal jaundice were enrolled, including diagnosed only (7260), simple phototherapy (82,990), intensive phototherapy or BET (27,972 infants). The cumulative incidences of ASD in each group was 0.57%, 0.81%, 0.77%, and 0.83%, respectively. The cumulative incidences of ADHD in each group was 2.83%, 4.04%, 3.52% and 3.48%, respectively. Jaundice groups were significantly associated with ASD, ADHD, or either one, even after all other extraneous maternal and neonatal variables were adjusted. After stratification, the associations were still existed in subgroup with birth weights ≥2500 grams and in male subgroup.
Conclusion:
Neonatal jaundice correlated with the ASD and ADHD. The associations were significant in infants of both sexes and with birth weights larger than 2500 grams.
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