title: Neonatal jaundice and increased risk of attention-deficit hyperactivity disorder: a population-based cohort study.
abstract: BACKGROUND
  Previous studies have posited conflicting results regarding the relationship between neonatal jaundice and the subsequent risk of attention-deficit hyperactivity disorder (ADHD). We therefore performed a large population study with a defined neonatal jaundice cohort to investigate the incidence and risk of physician-diagnosed ADHD in Taiwan.
  
  
  METHODS
  From 2000 to 2004, 24,950 neonatal jaundice cases and 69,964 matched nonjaundice controls were identified. At the end of 2008, the incidence rate and hazard ratios (HRs) of physician-diagnosed ADHD were calculated.
  
  
  RESULTS
  The incidence of ADHD was 2.48-fold greater in the jaundice cohort than in the nonjaundice cohort (3.84 vs. 1.51 per 100,000 person-years) in the study period. The HR of ADHD was substantially greater for male, preterm, and low-birth-weight infants with neonatal jaundice. The risk of developing ADHD in the jaundice cohort was greater after a diagnosis of neonatal jaundice for more than 6 years (HR: 2.64; 95% confidence interval: 2.13-3.28). The risk of ADHD increased for neonates with higher serum bilirubin levels requiring phototherapy and with longer admission days.
  
  
  CONCLUSIONS
  Neonates with jaundice are at high risk for developing physician-diagnosed ADHD during their growth period. A risk alert regarding neurologic consequences is urgently required after a neonatal jaundice diagnosis. Additional studies should be conducted to clarify the pathogenesis of these relationships.
authors: Department of Pediatrics, China Medical University Hospital, Taichung, Taiwan; College of Medicine, China Medical University, Taichung, Taiwan.
authors: Chang-Ching
authors: CC
authors: Wei
authors: Chun-Hung
authors: CH
authors: Chang
authors: Cheng-Li
authors: CL
authors: Lin
authors: Shih-Ni
authors: SN
authors: Chang
authors: Tsai-Chung
authors: TC
authors: Li
authors: Chia-Hung
authors: CH
authors: Kao
mesh_terms: D001289:Attention Deficit Disorder with Hyperactivity / Q000453:epidemiology / Q000209:etiology*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007567:Jaundice, Neonatal / Q000150:complications* / Q000453:epidemiology; D008297:Male; D012306:Risk; D013624:Taiwan / Q000453:epidemiology
keywords: Neonatal jaundice; attention-deficit hyperactivity disorder; population-based cohort study