Transient neonatal hyperinsulinaemic hypoglycaemia: perinatal predictors of length and cost of stay

Admission to neonatal care causes separation of infants from their parents, can adversely affect breast-feeding and is associated with painful procedures. Our aim was to identify perinatal factors and cost of care associated with transient neonatal hyperinsulinaemic hypoglycaemia (HH). Infants born after 35 weeks of gestation admitted because of hypoglycaemia were studied. The neonates were divided into two groups (HH and non-HH), and their length and cost of care were compared and perinatal factors predicting those outcomes explored. Forty of the 474 infants admitted with hypoglycaemia were diagnosed with HH. The HH group had a lower median (IQR) glucose level on admission compared to the non-HH group (p < 0.001). The median (IQR) cost of stay was higher in the HH group (p < 0.001). In the HH group, the GIR_max was significantly correlated with cost of stay (p < 0.001). GIR_max predicted a cost of stay > £9140 with an area under the ROC curve of 0.956. GIR_max > 13.9 mg/kg/min predicted admission cost > £9140 with 86% sensitivity and 93% specificity.

Conclusion: Transient neonatal HH was associated with a higher length and cost of stay in infants admitted for hypoglycaemia. The GIR_max can predict the length and cost of stay.