Background and objectives: Hyperbilirubinemia is associated with hearing impairment. This study was aimed to evaluate the incidence of hearing impairment among the term neonates with hyperbilirubinemia by using otoacostic emission (OAE) and auditory brainstem response (ABR). Methods: This one year hospital based prospective observational study was conducted from January 2017 to December 2017. A Total of 190 healthy term neonates with hyperbilirubinemia admitted at KIMS, Hubballi during the study period were studied. Most of the neonates were boys (60.53%) and boy to girl ratio was 1.53:1. History of consanguineous marriage was noted in 6.32% of the parents. The mean age was 4.73 ± 2.65 days. Majority of the neonates (97.37%) weighed between 2.5 to 3.5 Kg. The mean birth weight was 2.84 ± 0.84 Kg. The mean direct bilirubin levels were 0.88 ± 29 mg/dL and mean total bilirubin levels were 17.3 ± 2.58 mg/dL. During OAE-I, 33.16% of the neonates were advised to refer for second OAE and during OAE-II, 2.63% of the neonates were advised to undergo BERA. The incidence of hearing impairment based on BERA findings was 2.63%. 60.53% of the babies were born by LSCS while 39.47% were born through vaginal route and all the babies with hearing impairment had vaginal delivery while none of the baby with LSCS had hearing impairment (p=0.009). No association was found between hearing impairment in neonate with sex, age at admission and history of consanguineous marriage in parents and total bilirubin levels (p>0.050). Also the mean direct bilirubin, total bilirubin, birth weight, duration of NICU stay and age admission (p>0.050) were similar in babies with and without hearing impairment. Conclusion and interpretation: The present study showed incidence of hearing impairment as 33.16% based on OAE examination and 2.63% based on BERA.

Keywords: Auditory brainstem response; Hearing impairment; Hyperbilirubinemia.