Relation between Hyperbilirubinemia and Urinary Tract Infections in the Neonatal Period

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Jaundice is a frequently encountered problem in the neonatal period. It may be associated with hemolytic, enzymatic, metabolic, endocrine disorders or infections. Recently it has been thought to be one of the clinical signs of urinary tract infections (UTIs) in the neonatal period. Although they are concurrently observed, the association between neonatal jaundice and UTI is still unidentified. Common belief is that the bilirubin levels rise as a result of UTIs and jaundice may be considered as an important clinical sign in that period. However, there is no strong recommendation for screening UTI in all neonates with jaundice. It is only recommended to screen for UTI in neonates with prolonged hyperbilirubinemia and direct bilirubinemia. On the other hand, there are conflicting data on the protective effects of bilirubin on renal tissue. In this review, all those questionable topics were discussed in the light of clinical and experimental studies.