Assessment & Research

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

Amin et al. (2011) · Journal of autism and developmental disorders 2011
★ The Verdict

Neonatal jaundice gives a small nudge toward later ASD in term babies—note it and move on.

✓ Read this if BCBAs who screen infants or review medical histories during intake.
✗ Skip if Clinicians only treating older clients with no access to birth records.

01Research in Context

01

What this study did

The authors pooled 13 earlier studies that tracked babies with neonatal jaundice. They asked: did the yellow babies later get an autism diagnosis?

Only studies of full-term infants were kept. Pre-term babies were looked at separately.

02

What they found

Term infants who had jaundice showed slightly higher odds of later ASD. The effect was small but real.

In pre-term infants, the link disappeared.

03

How this fits with other research

Lee et al. (2022) later checked a huge Taiwan cohort and also saw the jaundice signal. They added hypoglycaemia, growth delay and facial anomalies to the watch list.

Atladóttir et al. (2015) widened the lens. They confirmed more jaundice in ASD kids, but saw the same pattern in other developmental disorders. Jaundice is not unique to autism.

Horinouchi et al. (2022) looked at UGT1A1 gene markers tied to jaundice and found NO link to ASD. This seems to clash with Robinson et al. (2011), but the first study measured actual yellow skin while the second measured DNA. Clinical jaundice and gene risk are different beasts.

04

Why it matters

Keep jaundice on your intake form. It is a weak red flag, not a siren. Pair it with other neonatal hits—low sugar, slow growth, birth distress—to decide who needs closer developmental watch.

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→ Action — try this Monday

Add a jaundice checkbox to your developmental history form; flag any term infant with jaundice plus one other neonatal complication for early monitoring.

02At a glance

Intervention
not applicable
Design
systematic review
Population
autism spectrum disorder
Finding
positive
Magnitude
small

03Original 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.

Journal of autism and developmental disorders, 2011 · doi:10.1007/s10803-010-1169-6