A newborn of a diabetic mother is at risk for all the following EXCEPT:

UP CHO - 2018

Obstetrics and Midwifery Nursing

Medium

Appeared in: UP CHO - 2018

Explanation

Infants of diabetic mothers (IDMs) develop hyperinsulinemia (high insulin levels) in utero in response to the mother's high blood sugar.
After birth, the maternal glucose supply is abruptly cut off, but the infant's high insulin levels persist.
This excess insulin rapidly drives glucose out of the bloodstream and into cells, causing hypoglycemia (low blood sugar), not hyperglycemia (high blood sugar).

Option A: Hypoglycemia is the most common metabolic complication in IDMs. The infant's persistent hyperinsulinemia after birth, combined with the cessation of maternal glucose supply, leads to a rapid drop in blood sugar.
Option C: Hypocalcemia is a known metabolic complication in IDMs, typically occurring within the first 72 hours of life. It is often related to a delayed response of the parathyroid hormone system.
Option D: Hyperbilirubinemia is a common finding in IDMs. It results from polycythemia (an excess of red blood cells), which is caused by chronic fetal hypoxia. The breakdown of these extra red blood cells after birth releases a large amount of bilirubin, leading to jaundice.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Neonatal complications in infants of diabetic mothers (IDMs) as background academic context rather than a clinical decision trigger.
Nurses must prioritize blood glucose monitoring for IDMs, typically starting within the first hour of life and continuing frequently per hospital protocol.
Early and frequent feeding (breast milk or formula) is a critical nursing intervention to prevent and manage hypoglycemia in this population.
A key nursing assessment includes observing for jitteriness or tremors, which can be signs of either hypoglycemia or hypocalcemia.

How to Approach the Question

First, identify the keywords: 'newborn,' 'diabetic mother,' and the negative lead-in 'EXCEPT'. This tells you to find the option that is NOT a risk.
Recall the core pathophysiology for an infant of a diabetic mother (IDM): maternal hyperglycemia causes fetal hyperinsulinemia.
Consider the transition at birth: the maternal glucose supply stops, but the infant's high insulin level persists.
Analyze the effect of high insulin without a high glucose supply. Insulin lowers blood sugar, so the infant is at high risk for hypoglycemia (low blood sugar).
Evaluate each option against this knowledge. Hypoglycemia is a risk. Hyperbilirubinemia (from polycythemia) is a risk. Hypocalcemia is a known associated risk.
The option that contradicts the pathophysiology is Hyperglycemia. Therefore, it is the correct answer to the 'EXCEPT' question.

Concept Tested & Keywords

Concept Tested: Neonatal complications in infants of diabetic mothers (IDMs)
Stem keywords: newborn, diabetic mother, risk
Lead-in keywords: EXCEPT
Negative lead-in flag: This is a negatively framed question asking you to identify the condition that is NOT a risk.

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E6 Ghai Essential Pediatrics(pp 26-904 of 913) p. 181-183

E6 Nelson Textbook of Pediatrics(2024) — Volume 1 p. 1151-1153