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Meta-Analysis
. 2011 Nov;41(11):1455-63.
doi: 10.1007/s10803-010-1169-6.

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

Sanjiv B Amin  1 , Tristram Smith, Hongyue Wang
Affiliations
Meta-Analysis

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

Sanjiv B Amin et al. J Autism Dev Disord. 2011 Nov.

Abstract

Using guidelines of the Meta-analysis of Observational Studies in Epidemiology Group, we systematically reviewed the literature on neonatal jaundice (unconjugated hyperbilirubinemia) and Autism Spectrum Disorder (ASD) in term and preterm infants. Thirteen studies were included in a meta-analysis. Most used retrospective matched case-control designs. There was significant heterogeneity (Q = 31, p = 0.002) and no evidence of publication bias (p = 0.12). Overall, jaundice, assessed by total serum bilirubin (TSB), was associated with ASD (OR, 1.43, 95% CI 1.22-1.67, random effect model). This association was not found in preterms (OR 0.7, 95% CI 0.38-1.02) but deserves further investigation since other measures of bilirubin such as unbound unconjugated bilirubin may be better predictors of neurotoxicity than TSB in preterms.

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Figures

Fig. 1
Fig. 1
An overview of bilirubin metabolism, bilirubin biochemical markers, and putative pathogenesis of jaundice mediated autism
Fig. 2
Fig. 2
Forrest plot showing individual and combined effect size estimates and 95% confidence interval (CIs) in the studies that evaluated the effect of neonatal jaundice on autism spectrum disorder. The weighting (filled square) given to the study in the overall pooled estimate, taking into account the number of subjects and the amount of between-study variation (heterogeneity). Error bars (−) indicate 95% CIs. The rhombus indicates combined effect size of 1.43
Fig. 3
Fig. 3
Begg’s funnel plot (with pseudo 95% CI) of the log odds ratio (logor) versus the standard errors of log odds ratio (SE of logor) in studies that evaluated the effect of neonatal jaundice on autism spectrum disorder. There was no publication bias (no asymmetry)
See this image and copyright information in PMC

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