Neonate of a diabetic mother is at risk for all the following EXCEPT?

Appeared in: NHM UP Staff Nurse - 2017

Explanation

Hyperglycemia (high blood sugar) is not a risk for the neonate immediately after birth.
The core pathophysiological issue is fetal hyperinsulinism, where the baby's pancreas produces too much insulin in response to the mother's high glucose levels.
After birth, the maternal glucose supply is cut off, but the infant's high insulin levels persist.
This state of hyperinsulinism causes a rapid consumption of the baby's own glucose stores, leading to hypoglycemia (low blood sugar), not hyperglycemia.

Option A: Hypoglycemia is the most common and immediate metabolic complication for an infant of a diabetic mother.
Option C: Hypocalcemia (low serum calcium) is a known metabolic complication in infants of diabetic mothers.
Option D: Hyperbilirubinemia (jaundice) is a common finding in these infants.

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 priority nursing action for an infant of a diabetic mother is to monitor for and prevent hypoglycemia by checking blood glucose levels soon after birth and ensuring early feeding.
Nurses must be vigilant for subtle signs of hypoglycemia, such as jitteriness, poor feeding, lethargy, or a weak cry, as these can indicate a need for urgent intervention.
What if? If the mother's diabetes was exceptionally well-controlled throughout the pregnancy (e.g., HbA1c near normal), the infant's risk for these complications is significantly lower. However, the risk is not zero, and routine screening protocols for at-risk infants should still be followed.

How to Approach the Question

First, identify the keyword 'EXCEPT'. This tells you that three of the options are known risks, and your task is to find the one that is not.
Recall the basic pathophysiology for an infant of a diabetic mother (IDM). The key concept is the relationship between maternal glucose and fetal insulin.
Remember that maternal glucose crosses the placenta, but maternal insulin does not. The fetus compensates for high glucose by making its own excess insulin.
Consider what happens at birth: the glucose supply from the mother is suddenly cut off.
Reason through the consequence: The newborn is left with high levels of insulin but no incoming glucose supply. This imbalance will cause blood sugar to drop, not rise.
This logic identifies hypoglycemia as a major risk and hyperglycemia as the exception.

Concept Tested & Keywords

Qzczh08A9nO-rB5UpTT8vd

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

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

Practise the full NHM UP Staff Nurse - 2017

Attempt every question from this paper in a timed mock, then review the full solution for each one.