A baby of a diabetic mother shows all, except?

HPSSC - 2015

Child Health Nursing (Pediatrics)

Medium

Appeared in: HPSSC - 2015

Explanation

Hyperglycemia (high blood sugar) is the correct answer because it is the condition NOT typically seen in a newborn of a diabetic mother.
The core issue is neonatal hypoglycemia (low blood sugar), not hyperglycemia.
After birth, the constant supply of glucose from the mother is severed, but the infant's pancreas continues to overproduce insulin in response to the memory of high glucose levels in utero.
This state of hyperinsulinism causes a rapid uptake of glucose from the blood into the cells, leading to a sharp drop in blood glucose levels within the first few hours of life.

Option A: A 'Large baby' is a classic feature of an infant of a diabetic mother. This is a direct result of fetal hyperinsulinemia.
Option B: Hyaline membrane disease, another name for Respiratory Distress Syndrome (RDS), is a known complication. High fetal insulin levels interfere with cortisol's ability to stimulate surfactant production, leading to immature lungs.
Option D: Macrosomia is the medical term for a 'large baby' (typically defined as a birth weight greater than 4000-4500 grams or above the 90th percentile). It is a hallmark sign of an infant of a diabetic mother, caused by the growth-promoting effects of excess fetal insulin.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Complications in an infant of a diabetic mother (IDM) as background academic context rather than a clinical decision trigger.
The priority nursing action for an infant of a diabetic mother is to monitor for and prevent hypoglycemia. This involves checking blood glucose levels within 30-60 minutes of birth and before feeds.
Early and frequent feeding (within the first hour of life) is a key intervention to provide the newborn with a glucose source and prevent a rapid drop in blood sugar.
Nurses must also perform a thorough respiratory assessment, as these infants are at high risk for RDS. Watch for tachypnea, grunting, and nasal flaring.

How to Approach the Question

First, identify the question type. This is a negative-framed question using the word 'except', which means you are looking for the option that is FALSE or not associated with the condition.
Recall the core pathophysiology of an infant of a diabetic mother (IDM). The key concepts are maternal hyperglycemia leading to fetal hyperinsulinemia.
Think about the effects of high insulin in the fetus: it acts as a growth hormone (causing a large baby/macrosomia) and it delays lung maturity (causing hyaline membrane disease/RDS).
Consider what happens immediately after birth: the glucose supply from the mother stops, but the baby's high insulin level persists. This mismatch will cause low blood sugar (hypoglycemia).
Evaluate each option based on this understanding. 'Large baby', 'Macrosomia', and 'Hyaline membrane disease' are all known complications.
'Hyperglycemia' is the opposite of what is expected (hypoglycemia), making it the correct answer to the 'except' question.

Concept Tested & Keywords

Concept Tested: Complications in an infant of a diabetic mother (IDM)
Stem keywords: baby, diabetic mother
Lead-in keywords: except
Negative lead-in flag: The question uses the word 'except', asking for the finding that is NOT present.

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E6 Nelson Textbook of Pediatrics(2024) — Volume 1 pp. 1151-1153, 1152-1154