Lai NM, Gerard JP, Ngim CF, et al. - Analyzing the link between total serum bilirubin (TSB) and kernicterus spectrum disorder (KSD), it was discovered that there exists insufficient high-quality evidence on the independent prognostic value of TSB for adverse neurodevelopmental outcomes in most neonatal populations.

• A total of 37 studies (n = 648,979) were selected from PubMed, EMBASE, and CENTRAL, 22 contributed meta-analysis data and 15 were summarized narratively.

• In infants with certain risk factors, TSB seems linked with KSD (adjusted odds ratio aOR: 1.10; 5 studies [n = 4,484]).

• However, in overall neonatal sample, no clear link of TSB (aOR 1.10; 1 study [n = 34,533]) or hyperbilirubinemia (aOR 1.00; 2 studies [n = 56,578]) with kernicterus or neurological diagnosis was found (moderate-certainty-evidence).

• By low-certainty-evidence from one study, probability of developing attention-deficit disorder (aOR 1.90) and autistic spectrum disorder (aOR 1.60, n = 56,019) is greater in infants with hyperbilirubinemia.

• There emerged certain clinical factors that appeared to have a link with KSD, although very few studies contributed to the analyses.