Abstract:  Objective · To investigate the risk factors of hearing damage in child patients with severe neonatal hyperbilirubinemia (NHB) and follow up their prognosis.  Methods · Clinical data of 106 newborns with severe NHB in neonatal ward of Shanghai Children’s Medical Center from June 2015 to June 2016 were retrospectively analyzed. According to total serum bilirubin (TSB) level, they were divided into three groups, severe NHB group (342.0 μmol/L<TSB peak <427.5 μmol/L), very severe NHB group (TSB peak range 427.5-513.0 μmol/L), and fatal NHB group (TSB peak > 513.0 μmol/L). Automatic auditory brainstem response (AABR) was used to evaluate the hearing ability of children in hospital, while those who got abnormal results would undergo diagnostic test of auditory brainstem response (ABR) when 3 months old. Auditory behavioral response of all 106 child patients at 3 and 6 months old were followed up.  Results · There were totally 106 cases in three groups, among which 33 cases (33/106, 31.13%) got abnormal results at hearing screening in hospital, 22 cases (22/86, 25.58%) in severe NHB group, 9 cases (9/16, 56.25%) in very severe NHB group, and 2 cases (2/4, 50.00%) in fatal NHB group. The difference between groups was statistically significant (all P<0.05). All 33 patients not passing AABR in hospital came to undergo diagnostic test of ABR through regular education by a specially assigned person when 3 months old. Two children were diagnosed mild hearing damage. One of them was considered being caused by tympanitis. All children had good situation of auditory behavioral response at 3 and 6 months old in follow-up.  Conclusion · Severe NHB is one of the high risk factors of hearing damage in neonates. The morbidity of hearing damage was higher with the increase of TSB level. The hearing damage caused by severe NHB might be reversible. It also suggested that the follow-up plan should be improved. The hearing damage caused by severe NHB might have no obvious effect on children in daily life, but long term follow-up of these children is still needed.

Key words: severe neonatal hyperbilirubinemia, hearing damage, risk factors, follow-up