Neonatal jaundice and the risk of autism

Newborns with neonatal jaundice had increased risks of developing ASD [autism spectrum disorder]” according to research by Mu-Hong Chen and colleagues* based in Taiwan.

Based on a large cohort of over 2000 newborns presenting with neonatal jaundice otherwise known as hyperbilirubinemia characterised by yellowing of the skin and the whites of the eyes, researchers looked at the frequency of a subsequent diagnosis of autism or other developmental conditions compared to 8000 age and gender matched infants who did not present with jaundice. Autism was more frequently reported in the jaundice group as was an increased frequency of developmental delay or speech and language disorder leading the authors to conclude that “Newborn exposure to hyperbilirubinemia was related to the increased risk of developing ASD, any developmental delay, and developmental speech or language disorder in later life”. This report adds to other research pointing to a potentially increased risk of autism when jaundice appears at birth.

The research by Chen and colleagues has some significant strengths based on the numbers of participants included for study and the methods of sampling based on the use of a national health database. Other studies from this research group have relied on similar methods of study.

Details on the possible mechanism(s) through which jaundice may confer a greater susceptibility to being diagnosed on the autism spectrum remain elusive. Given the frequency with which jaundice can occur in newborns in the general population (~60% according to some estimates) it is highly unlikely that this factor on it’s own is going to be ‘causative’ of autism. Whether this implies some genetic overlap between the risk of jaundice and autism or even greater inspection of early feeding practices using breast milk jaundice as a template however, is source for further investigation.

 

* Chen M-H. et al. Is neonatal jaundice associated with autism spectrum disorder, attention deficit hyperactivity disorder, and other psychological development? A nationwide prospective study. Res Autism Spec Disord. 2014; 8: 625-632.

Further commentary on this study can be found at: http://questioning-answers.blogspot.com/2014/05/neonatal-jaundice-and-risk-of-autism.html