A child born to a diabetic mother can have?

IGNOU PB Bsc Nsg Entrance-2017

Child Health Nursing (Pediatrics)

Medium

Appeared in: IGNOU PB Bsc Nsg Entrance-2017

Explanation

Infants of diabetic mothers (IDMs) are exposed to high levels of glucose in utero, which stimulates their own pancreas to produce excessive insulin (hyperinsulinemia).
After birth, the maternal glucose supply is suddenly cut off, but the newborn's hyperinsulinemic state persists.
This persistent high level of insulin rapidly drives glucose out of the bloodstream and into the cells, leading to neonatal hypoglycemia.
According to pediatric textbooks, hypoglycemia develops in approximately 15-50% of IDMs, with the lowest blood glucose levels typically seen 1-3 hours after birth.

Option B: Hyperglycemia (high blood sugar) is the condition experienced by the fetus in utero due to the mother's high glucose levels. After birth, the infant is prone to the opposite condition, hypoglycemia.
Option C: Hyperlipidemia (high levels of fats in the blood) is not a recognized primary or acute complication for a newborn of a diabetic mother. The main metabolic derangement is in glucose regulation.
Option D: Hyperthermia (high body temperature) is incorrect. These infants, especially if they are large for gestational age (macrosomic) or premature, are actually at a higher risk for hypothermia (low body temperature) due to factors like a large surface area and potential metabolic stress.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Complications in infants of diabetic mothers (IDM) as background academic context rather than a clinical decision trigger.
The primary nursing responsibility is the early identification and prevention of hypoglycemia in IDMs, as severe or prolonged low blood sugar can lead to seizures and permanent brain damage.
Nurses must ensure blood glucose is screened within 30-60 minutes of birth and that early feeding is established within the first hour.
What if? If the mother's diabetes was very well-controlled throughout the pregnancy (e.g., HbA1c less than 6.5%), the risk of neonatal hypoglycemia is significantly reduced, but the infant is still considered 'at-risk' and requires routine screening.

How to Approach the Question

First, identify the core clinical scenario: a newborn of a 'diabetic mother'.
Recall the key pathophysiological process associated with maternal diabetes. The mother has high blood sugar (hyperglycemia).
Think about how this affects the fetus. Glucose crosses the placenta, so the fetus also becomes hyperglycemic. The fetus compensates by producing extra insulin (hyperinsulinemia).
Now, consider the moment of birth. The glucose supply from the mother is cut off, but the baby's body is still in a state of high insulin production.
Predict the outcome: High insulin with no incoming glucose will cause the baby's blood sugar to drop sharply. This condition is hypoglycemia.
Evaluate the options based on this prediction. Hypoglycemia directly matches the expected outcome.

Concept Tested & Keywords

Concept Tested: Complications in infants of diabetic mothers (IDM)
Stem keywords: child, born, diabetic mother
Lead-in keywords: can have
Clinical cues: Age/sex group narrows the expected diagnosis, intervention, or normal reference range.

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