G210(P) Perinatal predictors of neonatal hyperinsulinism: length and cost of stay

Aims To identify perinatal factors associated with neonatal hyperinsulinism (HI) and to investigate the predictive value of insulin levels and the maximum glucose infusion rate (GIR) on the length and cost of admission for neonatal HI. Methods In this single-centre study, infants born between 1/1/2012 and 31/12/2015 above 35 weeks gestation, who were admitted for hypoglycaemia were retrospectively identified. Hypoglycaemia was defined as a glucose level 8 mg/kg/min. Maternal and perinatal factors were compared between the two groups. In the HI group, the predictive value of insulin levels and maximum GIR on length and cost of admission was explored. Results There were 474 babies with hypoglycaemia, 42 of whom were identified as having HI. The HI group more often had hypoglycaemic symptoms (45.5% versus 26.5%, p=0.009) and lower median (IQR) glucose levels on admission [1.75 (1.4–2.1) versus 2.10 (1.8–2.4) mmol, p 21 days and cost >£16 000 with an area under the curve of 0.93 for both. A maximum GIR >13.9 mg/kg/min predicted an admission length >21 days and a total cost >£16 000 with 88% sensitivity and 82% specificity. Conclusion Hypoglycaemic symptoms and lower glucose levels on admission were more common in infants with hyperinsulinism. The maximum GIR was a good predictor of the length and cost of care.