Monica L Kujabi1, Jesper P Petersen2, Mette V Pedersen2, Erik T Parner3, Tine B Henriksen2. 1. Perinatal Epidemiology Research Unit, Department of Pediatrics, Aarhus University Hospital, Aarhus, Denmark. monica.kujabi@gmail.com. 2. Department of Pediatrics, Aarhus University Hospital, Aarhus, Denmark. 3. Department of Public Health, Section for Biostatistics, Aarhus University, Aarhus, Denmark.
Abstract
BACKGROUND: Two meta-analyses concluded that jaundice was associated with an increased risk of autism. We hypothesize that these findings were due to methodological limitations of the studies included. Neonatal jaundice affects many infants and risks of later morbidity may prompt physicians towards more aggressive treatment. METHODS: To conduct a systematic literature review and a meta-analysis of the association between neonatal jaundice and autism with particular attention given to low risk of bias studies. Pubmed, Scopus, Embase, Cochrane, and Google Scholar were searched for publications until February 2019. Data was extracted by use of pre-piloted structured sheets. Low risk of bias studies were identified through predefined criteria. RESULTS: A total of 32 studies met the inclusion criteria. The meta-analysis of six low risk of bias studies showed no association between neonatal jaundice and autism; cohort studies risk ratio 1.09, 95% CI, 0.99-1.20, case-control studies odds ratio 1.29 95% CI 0.95, 1.76. Funnel plot of all studies suggested a high risk of publication bias. CONCLUSIONS: We found a high risk of publication bias, selection bias, and potential confounding in all studies. Based on the low risk of bias studies there was no convincing evidence to support an association between neonatal jaundice and autism. IMPACT: Meta-analysis of data from six low risk of bias studies indicated no association between neonatal jaundice and autism spectrum disorder. Previous studies show inconsistent results, which may be explained by unadjusted confounding and selection bias. Funnel plot suggested high risk of publication bias when including all studies. There is no evidence to suggest jaundice should be treated more aggressively to prevent autism.
BACKGROUND: Two meta-analyses concluded that jaundice was associated with an increased risk of autism. We hypothesize that these findings were due to methodological limitations of the studies included. Neonatal jaundice affects many infants and risks of later morbidity may prompt physicians towards more aggressive treatment. METHODS: To conduct a systematic literature review and a meta-analysis of the association between neonatal jaundice and autism with particular attention given to low risk of bias studies. Pubmed, Scopus, Embase, Cochrane, and Google Scholar were searched for publications until February 2019. Data was extracted by use of pre-piloted structured sheets. Low risk of bias studies were identified through predefined criteria. RESULTS: A total of 32 studies met the inclusion criteria. The meta-analysis of six low risk of bias studies showed no association between neonatal jaundice and autism; cohort studies risk ratio 1.09, 95% CI, 0.99-1.20, case-control studies odds ratio 1.29 95% CI 0.95, 1.76. Funnel plot of all studies suggested a high risk of publication bias. CONCLUSIONS: We found a high risk of publication bias, selection bias, and potential confounding in all studies. Based on the low risk of bias studies there was no convincing evidence to support an association between neonatal jaundice and autism. IMPACT: Meta-analysis of data from six low risk of bias studies indicated no association between neonatal jaundice and autism spectrum disorder. Previous studies show inconsistent results, which may be explained by unadjusted confounding and selection bias. Funnel plot suggested high risk of publication bias when including all studies. There is no evidence to suggest jaundice should be treated more aggressively to prevent autism.
Authors: Vinod K Bhutani; Ann R Stark; Laura C Lazzeroni; Ronald Poland; Glenn R Gourley; Steve Kazmierczak; Linda Meloy; Anthony E Burgos; Judith Y Hall; David K Stevenson Journal: J Pediatr Date: 2012-10-05 Impact factor: 4.406
Authors: Jon Baio; Lisa Wiggins; Deborah L Christensen; Matthew J Maenner; Julie Daniels; Zachary Warren; Margaret Kurzius-Spencer; Walter Zahorodny; Cordelia Robinson Rosenberg; Tiffany White; Maureen S Durkin; Pamela Imm; Loizos Nikolaou; Marshalyn Yeargin-Allsopp; Li-Ching Lee; Rebecca Harrington; Maya Lopez; Robert T Fitzgerald; Amy Hewitt; Sydney Pettygrove; John N Constantino; Alison Vehorn; Josephine Shenouda; Jennifer Hall-Lande; Kim Van Naarden Braun; Nicole F Dowling Journal: MMWR Surveill Summ Date: 2018-04-27