Division of Neonatology, Department of Pediatrics, The University of Rochester School of Medicine and Dentistry, P.O. Box 651, 601 Elmwood Avenue, Rochester, NY 14642, USA.
J Autism Dev Disord. 2011 Nov;41(11):1455-63. doi: 10.1007/s10803-010-1169-6.
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.
我们采用观察性研究荟萃分析组的指南，系统地回顾了足月和早产儿的新生儿黄疸（未结合高胆红素血症）与自闭症谱系障碍（ASD）的文献。有 13 项研究纳入荟萃分析。大多数研究采用回顾性匹配病例对照设计。存在显著的异质性（Q=31，p=0.002），且无发表偏倚的证据（p=0.12）。总的来说，通过总血清胆红素（TSB）评估的黄疸与 ASD 相关（OR，1.43，95% CI 1.22-1.67，随机效应模型）。这一关联在早产儿中并未发现（OR 0.7，95% CI 0.38-1.02），但值得进一步研究，因为与 TSB 相比，胆红素的其他测量值，如未结合的 unconjugated 胆红素，可能是早产儿神经毒性的更好预测指标。
