Home > Science > Autism: What’s Jaundice Got to do with it?

Autism: What’s Jaundice Got to do with it?

Staff bloggers Alycia Halladay, Ph.D., Director of Environmental Sciences  and Leanne Chukoskie, Ph.D., Assistant Director of Science Communication and Special Projects

A study published on Monday in Pediatrics revealed that newborns who experienced jaundice were at greater risk for a later diagnosis of autism spectrum disorders. Jaundice is a common condition where bilirubin is not properly excreted by the liver, builds up in the blood and leads to a slight yellow pigment of the skin.  Bilirubin is a neurotoxin and it is well established that untreated severe jaundice can lead to brain damage and even death. Fortunately, despite the fact that jaundice is very common in newborns, it usually resolves with minimal or no intervention within a few days of birth.

Previous studies have investigated the potential for increased risk of ASD following jaundice with mixed conclusions. The advantage of this study is that the researchers used a large health registry database in Denmark including over 700,000 birth and associated developmental health records. The researchers looked at the development of 35,766 children diagnosed with perinatal jaundice (4.9% of the entire study population). They looked for children diagnosed with ASD as well as a broader definition of disorders of psychological development, which included speech delay.  The risk of an ASD was found to be about 52% greater in children who experienced jaundice as newborns versus those who did not.

This may be an overestimate because factors such as season of birth, gestational age, parental age, gender, and the birth order of the child were not considered in this comparison. When these factors were considered, the overall risk increase was no longer statistically reliable.  However an interesting pattern emerged from individually considering the factors.

Although preterm children typically experience a greater risk of autism by virtue of the challenges of prematurity, it is the full term babies that have an increased risk for ASD after exposure to jaundice.  The authors speculate that there may be some unique window of vulnerability in brain development around 40 weeks gestational age that can explain this finding.

Another interesting relationship emerged from looking at cases from mothers who had previously had children versus those giving birth for the first time. Jaundice increased the risk for developing an ASD in children who were second or later born, but conveyed no increased risk for first born children. This effect is also a bit of a scientific mystery, however we do know that second and later-born children can be exposed to maternal antibodies that accumulate from previous pregnancies.

Lastly, the authors found that birth during the winter months was statistically associated with greater ASD risk than birth in the summer months.  Exposure to daylight helps to break down bilirubin, so it is possible that individuals born in summer months, though diagnosed with jaundice had lower levels of bilirubin in their blood simply because they were exposed to more sunlight.  The authors also note that sunlight is required for Vitamin D synthesis and low light levels in the winter may alter the body’s ability to as synthesize Vitamin D. Vitamin D deficiency is another autism risk factor under investigation.  Autism Speaks is currently supporting a study examining how Vitamin D levels at birth and genes for the Vitamin D receptor are related to a later autism diagnosis.

In summary, it is important to note that although this paper brings many new considerations, it does not establish that jaundice causes autism.  Instead, this paper reports on the risk of developing ASD after exposure to jaundice. This risk is significantly modified by several factors. Data from this study suggests that babies with jaundice who were born prior to 37 weeks gestation have little to no increased risk of ASD.  However, the data also indicate a substantially elevated risk for full-term babies born to mothers with previous pregnancies and also full-term babies that were born during winter months.  Hopefully, this and other information about medical conditions at birth will lead to the further development of screening tools to identify individuals at risk for a later autism diagnosis.  Before that is done, scientists need to determine the mechanism by which jaundice may be contributing to the risk of developing ASD.  Further research will been needed to determine whether bilirubin is itself an environmental risk factor, or if jaundice is a consequence of both genetic and environmental effects that elevate the risk of developing autism.

  1. Debbie Gillispie
    October 15, 2010 at 1:07 pm

    Sorry but my daughter was jaundice and no autism my son was clean as can be and is autistic

  2. RAJ
    October 15, 2010 at 1:41 pm

    Juul-Dam et al also found an increased risk for autism associated with jaundice in the PDD/NOS category.

    http://pediatrics.aappublications.org/cgi/content/full/107/4/e63#T1

    While Croen et al did not:

    http://www.ncbi.nlm.nih.gov/pubmed/15687420

    Maimberg et al previously reported a four fold risk for autism in newborns transferred to a neonatal ward diagnosed with jaundice:

    http://www.ncbi.nlm.nih.gov/pubmed/19000294

  3. October 15, 2010 at 2:03 pm

    My oldest girl that’s valedictorian had jaundice but born in May. Son w/ highfunctioning autism born in Jan. had no jaundice. $th child, a boy born in April that may have Asperger’s had jaundice needing lights. 5th child, a girl in Oct. 2002, also needed lights but is very gifted. Who knows, bet it’s more related to Vit. D. levels…

  4. Katie wright
    October 15, 2010 at 2:52 pm

    You failed to mention the obvious impact of the Hep B vaccine!

    This “heavy duty vaccine” in the words of former NIH director Bernadine Healey, is given within hours of birth. Jaundice reflects poor liver functioning. Perhaps these babies are poor methylators and are the subset who most likely experience adverse vaccine reactions.

    My son had jaundice and got the Hep B. They don’t need to even ask your permission before the shot. Insane

  5. Suzanne Baird
    October 15, 2010 at 3:15 pm

    I think the point of what has been learned from this study is not that jaundice or anything else is “THE” cause of autism, but that it might be one of many possible causes. My son has developmental delays which fall on the autism spectrum. All premature babies are at risk for developmental delays whether or not they are jaundiced…this makes complete sense. Full term babies with no obvious delays could potentially become impaired if the jaudice is not taken seriously. My autistic son was full-term and was severely jaundiced. My pediatricians office was impossible to deal with…didn’t want to do the paperwork on a Saturday and I had to fight at the time to get my son’s jaundice tested and treated. His bilirubin level was at 15 on Saturday (2 days after birth). The hospital staff were concerned, asked us to keep him in the sun and said they’d re-test on Monday. If they/we/anyone had knowledge that this might have put my baby at risk for autism or developmental delays of any kind…it should have been taken far more seriously. The lesson of the study is that we should pay attention to jaundice. But it is clear to me, that there is more than one cause of autism, just as there are many causes to all types of delays or impairments. Let’s keep looking for clues and not rule out anything – including jaundice related risk – until we have solid definitive answers.

    • Emily
      January 11, 2011 at 12:16 pm

      My 3 1/2 year old son also has developmental delays that fall on the Autism Spectrum. He had fairly severe jaundice at birth at peaked at 24 (so they believe). He was hospitalized on lights for a week, and in home lights for another week. I have often wondered if his jaundice had anything to do with his sensory issues and language delays. When I approached his pediatrician regarding the possibilty he quickly changed the subject. Somehow this didn’t surprise me since he sent us home with his numbers quickly climbing. It will be interesting to see where this study goes.
      How old is your son now, and how is he doing?

  6. Ericka Soto
    October 15, 2010 at 3:21 pm

    My son Joey who now is 6 years old has hig functional autism, and he did not have jaundice, he was diagnosed on June of 2010. His little brother Diego was born on November of 2009 and had jaundice, he is having a typical development and I am amazed of the thing that he is capable of doing, he is almost walking. So this is very confusing to me I will just go with the flow and be very watchful because I don’t know what to think now.

  7. October 15, 2010 at 8:20 pm

    sounds inconclusive to me. why post this and confuse the general public further?

  8. becky
    October 16, 2010 at 7:19 am

    My son was full-term, born with jaundice, and has high functioning autism. Makes you wonder.

  9. Mary
    October 17, 2010 at 10:09 pm

    I am a parent of a six year old boy. I have been trying to get help for my son since he was four years old.And I am having a hard time getting anyone to help him. The school does not want to work with him all they do is send him home. The doctors tell me all the time he is to young they do not want to say he is autistic because of age or insurance will not want to cover. I have gotten to the point were it seems like no one is there to help or wants to help my son. I am lost. I guess what I am trying to say does anyone out there know what I can do for my son please tell me.

    Thank you
    Mary

    • vsheehan
      October 24, 2010 at 4:18 pm

      Mary
      Get a new peditrition. Study after study has shown early intervention is crucial. Consider looking into Floortime or RDI plus the usual OT ST and a play group based on floortime. For a new Peditrition join your local AUtism yahoo email group or the the group closets to you. Ask them for recomendations for a Ped Dr. or Neurologist. Plus try to see a Ped in the nearest teaching hospital as they will be better informed(hopefully) and insurance always cover them.
      Good Luck. remember to go to Yahoo groups and find your local AU email group they will be the best help.

  10. Katie Wright
    October 18, 2010 at 11:21 am

    Mary, how terrible!
    #1 The pediatricians are doing you no favors by not “labelling” your son. That is so absurd. A “label” is the least of our problems. Pediatricians need to join us in reality. Labels are not hurting our kids- the lack of services is. Your son cannot get the help he needs without the diagnosis. Take him to another pediatrician.
    #2 The school is required to provide an Individual Educational Plan or IEP for kids w/ ASD.

    Try the Talk about curing autism website- they provide a step by step guide to dealing with these problems. The National Autism Association and Generation Rescue also provide free parent mentoring.

    Good Luck!

  11. Mary
    October 18, 2010 at 11:45 am

    Thank you for your help. I need all the luck I can get right now.

    Thank you
    Mary

  12. Denise Goller
    October 18, 2010 at 1:28 pm

    I had my second son, birth in late march 2006, 38 weeks, c-section, i lived north with no sun, vitamin D from sun clearly lacking, 5 days after birth i took him home and he had yellow eyes, yellow,dark skin and my sister said, oh he is jaundice!! no one, not one doctor, nurse, anyone, mentioned it, still allowed him to go home or told me!! by two months after his dTap and hep B, he was clearly on his way to autism.

    to mary, move to another state if you have to, scream, get him ABA now, call everyone you know, i did and found two teachers to come to my home at my expense for 6 days a week and they got my son talking, learning!! good luck, i will pray for you.
    thanks,
    denise

  13. Mary
    October 18, 2010 at 8:29 pm

    to Denise Goller LOL moving is not something I can do I have two step kids here too. And my kids father lives here to thanks for the advise. ANd thank you for your prays I sure can use them. And I am getting him extra speech in my home two times a week but that just started this month.I have screamed till I was blue in the face. And what is ABA. Sorry not to sure what that means.

    Thank you
    Mary

  14. Mary
    October 25, 2010 at 8:50 pm

    To Vsheehan,
    Thank you so much for everyones help.All of yall have been really big help.ANd I will look up those groups you told me about I will be doing that. And as for his PED. he has a really good one he has not been the doctor that is holding things up. It was the ones the school brought in and I have to wait till DEC. to get him into the one I got threw my PED. after the school was no help to me.

    THANK you
    MAry

  15. Mary
    December 9, 2010 at 10:14 pm

    I wanted to thank all the people that sent me in the right direction for my son. I have gotten all the things together and the right people are helping my son now and he is autistic. I am just glad to have finally gotten him the help he really needed. And all of you that commented on what I had to say really helped me go in the right direction and I wanted to say Thank you all so very much.

    Thanks,
    Mary

  16. Lou
    May 5, 2011 at 7:41 pm

    That could explain Dr. Cannell’s theory over vitamin D and autism. I believe it was in 2007 that he came up with this theory that vitamin D deficiency may have had to do with autism. So far, it is looking more and more like that it could be the root cause. Also, case reports involving high dose vitamin D therapy for autistic kids (no difference than treating vitamin D deficiency because practically all kids that were tested had very low level).

  1. October 18, 2010 at 12:05 pm

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s

Follow

Get every new post delivered to your Inbox.

Join 1,054 other followers

%d bloggers like this: