Neonatal jaundice, attention deficit hyperactivity disorder and familial effects: A Swedish register study with sibling analysis.


Le Ray I(1)(2), Wang C(2), Almqvist C(2)(3), Lichtenstein P(2), D'Onofrio BM(2)(4), Johansson S(5)(6), Larsson H(2)(7), Rosenqvist MA(2).
Author information:
(1)Department of Neonatal Intensive Care, Strasbourg University Hospital, France.
(2)Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
(3)Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.
(4)Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN, USA.
(5)Department of Clinical Science and Education, Södersjukhuset, Stockholm, Sweden.
(6)Department of Medicine Solna, Clinical Epidemiology Unit, Karolinska Institutet, Stockholm, Sweden.
(7)School of Medical Sciences, Örebro University, Örebro, Sweden.


AIM: Neonatal jaundice is associated with higher risk of attention deficit hyperactivity disorder (ADHD), but it is unclear if the association is influenced by genetic and other familial factors. In this large population-based study, we investigated the association between neonatal jaundice and ADHD while adjusting for familial factors. METHODS: We linked several Swedish registers to identify all singleton births without congenital malformations between 1992 and 2000 (n = 814 420, including 384 290 full siblings) and followed them up until 2009. We calculated hazard ratios (HRs) for the association between neonatal jaundice and ADHD, adjusting for pregnancy, delivery and neonatal characteristics including prematurity, and parental age and education. We repeated the analyses among siblings to adjust for shared familial factors. RESULTS: At a population level, children treated for neonatal jaundice had an increased risk of ADHD (adjusted HR (aHR): 1.13, 95% CI: 1.05-1.22). In the sibling comparisons, there was no clear association between neonatal jaundice and ADHD (aHR: 1.03, 95% CI: 0.82-1.29). CONCLUSION: We found no evidence of an independent association between neonatal jaundice and ADHD within siblings in this large population-based study, suggesting that the association is probably influenced by shared familial factors, such as parental genetic and/or lifestyle effects.