Jaundice&Autism

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Hi, Everyone....I think we already did our own survey on this.

From _Medscape Medical News_ (http://www.medscape.com/news)

Jaundice in Newborns Linked to Autism

Fran Lowry

October 21, 2010 — Jaundice in full-term newborn infants is associated with

an increased risk for autism and other psychological development

disorders, according to a new study.

The study, which included all children born in Denmark from 1994 to 2004,

found that full-term neonates exposed to jaundice had as much as an 88%

increased risk of being diagnosed with a psychological development disorder

compared with unexposed neonates.

" The knowledge that jaundice is associated with autism is one more clue to

the puzzle towards finding its etiology, " lead author Rikke Damkjaer

Maimburg, MPH, PhD, from Aarhus University, in Denmark, told Medscape Medical

News. " If children with autism are genetically disposed to develop autism,

there might be overlaps in the etiology between autism and jaundice. If

exposure to jaundice can give autism, then we need to look at our treatment

procedures. "

Their results were published online October 11 in Pediatrics.

Link With Hyperbilirubinemia

Dr. Maimburg and colleagues decided to explore the association between

neonatal jaundice, autistic disorders, and other psychological development

problems after noticing in an earlier study that children later diagnosed with

autism were twice as likely to be admitted to neonatal intensive care units

as children without autism, even after controlling for low birth weight,

malformations, preterm birth, and low Apgar scores.

" I wondered why, after controlling for all the risk factors for being

admitted to the neonatal ward, that this occurred. Then I found out that the

most common reason for being readmitted was because of hyperbilirubinemia, "

Dr. Maimburg told Medscape Medical News.

Neonatal jaundice is seen in 60% of term infants and, in most cases,

resolves within the first week of life. However, prolonged exposure to high

bilirubin levels is neurotoxic and can cause lifelong developmental problems.

The investigators determined jaundice exposure status and diagnoses of

disorders of psychological development in 733,826 children. They found that the

excess risk of developing a psychological development disorder after

exposure to jaundice as a neonate was between 56% (hazard ratio

---

, 1.56; 95%

confidence interval [CI], 1.05 - 2.30) and 88% (HR, 1.88; 95% CI, 1.17 -

3.02).

The excess risk for infantile autism was 67% (HR, 1.67; 95% CI, 1.03 -

2.71). This risk was higher for children of parous women (HR, 2.71; 95% CI,

1.57 - 4.66) and for children born between the months of October and March

(HR, 2.21; 95% CI, 1.24 - 3.94).

The risk for infantile autism disappeared if the child was conceived by a

primiparous woman (HR, 0.58; 95% CI, 0.18 - 1.83) or was born between April

and September (HR, 1.02; 95% CI, 0.41 - 2.50), and similar risk patterns

were noted for the entire spectrum of autistic disorders.

Dr. Maimburg said that physicians should tell parents that jaundice, for

the most part, is a normal condition but also advise them about ways to

prevent the development of hyperbilirubinemia, and instruct them on when to

contact health professionals. " I hope that this study will promote more

research into jaundice and child development, " she added.

Screen More Carefully

Asked to comment on this study, Levy, MD, from Children's Hospital of

Philadelphia, Pennsylvania, and a member of the Center for Autism Research

at the hospital, said she thought it was well-done.

" The population they were using gives a unique opportunity because the

population is so large, and it is also self-contained, so they can track a

number of different outcomes, " Dr. Levy noted. " By having such a big

population, they can look at a number of factors more quickly than in a

prospective

study, or even a retrospective study. "

Dr. Levy, who is also a member of the American Academy of Pediatrics

subcommittee on autism, added: " I hope that the impact of this study will result

in the addition of term babies with hyperbilirubinemia to a higher risk

group of children who need to be screened more carefully. "

Dr Maimburg and Dr Levy have disclosed no relevant financial

relationships.

Pediatrics. Published online October 11, 2010.

Medscape Medical News © 2010 WebMD, LLC

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