A newborn infant of a diabetic mother may be at risk for all of the following except?

UP CHO - 2018

Child Health Nursing (Pediatrics)

Medium

Appeared in: UP CHO - 2018

Explanation

The question asks to identify the condition that is NOT a risk for an infant of a diabetic mother (IDM).
After birth, the continuous supply of glucose from the mother is stopped, but the infant's pancreas continues to produce high levels of insulin.
This state of hyperinsulinism leads to a rapid decrease in the infant's blood sugar, causing hypoglycemia (low blood sugar), not hyperglycemia (high blood sugar).
Therefore, hyperglycemia is the exception and the correct answer.

Option A: Hypoglycemia is the most common and immediate metabolic complication for an infant of a diabetic mother due to persistent fetal hyperinsulinism after birth.
Option C: Hypocalcemia is a known risk for infants of diabetic mothers, typically occurring within the first 72 hours of life, often related to a delayed parathyroid hormone response.
Option D: Hyperbilirubinemia is a common complication, often resulting from polycythemia (increased red blood cell mass) and subsequent breakdown of these excess cells.

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.
Nurses must anticipate hypoglycemia in any infant of a diabetic mother and act proactively.
The priority nursing action is to monitor the infant's blood glucose within the first hour of life and ensure early feeding to prevent neurological injury from low blood sugar.
What if? If the mother's diabetes was very well-controlled throughout the pregnancy, the infant's risk for these complications is significantly lower, but not zero. Vigilant monitoring is still required.

How to Approach the Question

First, identify the keywords in the stem: 'newborn infant,' 'diabetic mother,' and the negative lead-in 'except'.
The word 'except' signals that three of the options are true risks, and one is false. Your task is to find the false one.
Recall the core pathophysiology: High maternal glucose causes high fetal insulin. After birth, the glucose supply stops, but the high insulin remains.
Evaluate each option based on this pathophysiology. Ask yourself: 'Does high insulin after birth cause this?'
Hypoglycemia (low sugar) is a direct result. Hypocalcemia and hyperbilirubinemia are known associated risks.
Hyperglycemia (high sugar) contradicts the pathophysiology of persistent high insulin. This makes it the most likely exception.

Concept Tested & Keywords

Concept Tested: Complications in Infants of Diabetic Mothers (IDM)
Stem keywords: newborn infant, diabetic mother, risk
Lead-in keywords: except
Clinical cues: Age/sex group narrows the expected diagnosis, intervention, or normal reference range.
Negative lead-in flag: This is a negative-lead-in question, asking for the exception.

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