Neonatal hyperbilirubinemia, phototherapy and risk of autism

Abstract

Purpose Autism is developmental disorder marked by social impairment, communication deficits and restricted or stereotypic behaviors. The causes of autism are unknown, but likely involve genetic susceptibility and environmental factors. Studies have suggested an association between obstetric and neonatal complications, including neonatal hyperbilirubinemia and autism (Juul-Dam, 2001; Finegan, 1979). These studies involved small samples and are difficult to interpret. In contrast, a recent study based on review of a large clinical database reported that neonatal hyperbilirubinemia was not associated with increased risk. (Croen, 2005) Methods The New Jersey Answers for Autism Survey is a voluntary, Autism Spectrum Disorders (ASD) registry. Participants include parents of children with an ASD and adults with an ASD. Goals of the Survey include delineation of autism subtypes, identification of autism risk factors and longitudinal monitoring of ASD in a large, diverse, cohort. Current Survey enrollment is approximately 1,000 subjects between the ages of 2 and 65, and includes a significant number of African-American, Latino and Asian participants. Results Of a total 998 Survey respondents, 25% reported neonatal hyperbilirunemia, consistent with published rates for the U.S. population. A significant number of these participants (15.9%), however, reported phototherapy treatment for hyperbilirubinemia. This rate for neonatal phototherapy is approximately five times greater than the expected rate of occurrence (p-value