Objective To explore the application effects of automated auditory brainstem response（AABR） in neonatal hearing screening. Methods A total of 1447 neonates born in our hospital from January 2017 to October 2020 were selected and randomly divided into AABR group and control group. AABR group was screened by AABR method in the initial screening and rescreening

while the control group was screened by otoacoustic emission（OAE） method in the initial screening and rescreening

the pass rates of initial screening

rescreening

and screening accuracy of the two groups were compared

and the screening results of AABR method for the neonates with different gestational weeks

diseases and birth weight were analyzed. Results The failure rates of initial screening and rescreening in the AABR group were lower than those in the control group（7.19% vs 18.04% and 5.18% vs 10.37%）（P<0.05）; the difference of AABR screening results among different gestational weeks was statistically significant（P<0.05）. The results of pairwise comparison between pregnant groups showed that the failure rates of initial screening and rescreening of neonates with gestational age < 28 weeks were higher than those with gestational age 28-37 weeks and those with gestational age > 37 weeks（P<0.05）; the failure rates of initial screening and rescreening of neonates with diseases were higher than those without diseases（P<0.05）; there was a significant difference in the results of ABR screening among neonates with different birth weights（P<0.05）

the results of pairwise comparison showed that the failure rate of neonates with weight < 2500 g was higher than those with weight 2500～4000 g and weight > 4000 g（P<0.05）; there was no significant difference in rescreening results（P>0.05）. Conclusion AABR method can improve the accuracy of neonates hearing screening

and the failure rate of hearing screening is higher in neonates with gestational age < 28 weeks

disease at birth and low birth weight. Therefore

attention should be paid to this kind of neonates and hearing rescreening should be strengthened to detect the neonates with hearing impairment as soon as possible.