Background: Neonates born to high-risk pregnancies are susceptible to hearing loss, which can adversely affect speech, language development, and cognitive function. Early detection of hearing loss is crucial for timely intervention. Otoacoustic emissions (OAEs) testing is a non-invasive, efficient, and reliable method for detecting hearing impairment in neonates. Objective: The primary aim of this study was to evaluate the hearing abilities of high-risk neonates using otoacoustic emissions (OAE) tests, which are effective for early screening of hearing loss. Methods: A prospective study was conducted involving high-risk neonates admitted and stabilised in NICU of a tertiary care hospital over a period of 1 year. The hearing evaluation was performed using OAE testing, focusing on detecting otoacoustic emissions (both transient and distortion product) from the cochlea, as an indicator of hearing ability. Results: Out of 400 high-risk neonates, Hearing screening using automated otoacaustic emissions test (OAEs) device in high risk neonates revealed approximately 9.75% of pathologic result in which all having bilaterally affected ear. The significant independent risk factors in this study population were baby born to Consanguineous Marriage, neonate requiring admission in NICU for Respiratory distress, Hyperbilirubinimia, Delayed cry at birth and Low birth weight with Preterm baby. Conclusion: OAE testing proves to be a valuable tool for early detection of hearing impairment in high-risk neonates. This method can aid in the early identification and intervention of hearing loss, which is vital for the developmental progress of affected infants.

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