A full-term infant who is large for gestational age should be monitored for which risk?

A full-term infant who is large for gestational age should be monitored for which risk?

• A. Hypotension
• B. Hypothermia
• C. Hypocalcemia
• D. Hypoglycemia

Answer: (D)

When a newborn is large for gestational age, especially if the mother has diabetes, the baby is exposed to high glucose levels in the womb. This stimulates the fetal pancreas to make more insulin. After birth, the supply of maternal glucose stops, but the baby's high insulin level remains for a while, driving glucose into cells and dropping the blood glucose level. That makes hypoglycemia the most likely risk to monitor in the first hours of life. Signs to watch for include jitteriness, poor feeding, lethargy, or even breathing difficulties or seizures if levels are very low. Early feeding and glucose monitoring are essential to prevent problems. Other options aren’t as characteristic for this scenario: hypotension isn’t a typical immediate risk tied to being large for gestational age; hypothermia can occur but isn’t the hallmark risk here; hypocalcemia can occur in infants of diabetic mothers, but hypoglycemia is the more common and clinically important concern to monitor in a term, large baby.

When a newborn is large for gestational age, especially if the mother has diabetes, the baby is exposed to high glucose levels in the womb. This stimulates the fetal pancreas to make more insulin. After birth, the supply of maternal glucose stops, but the baby's high insulin level remains for a while, driving glucose into cells and dropping the blood glucose level. That makes hypoglycemia the most likely risk to monitor in the first hours of life.

Signs to watch for include jitteriness, poor feeding, lethargy, or even breathing difficulties or seizures if levels are very low. Early feeding and glucose monitoring are essential to prevent problems.

Other options aren’t as characteristic for this scenario: hypotension isn’t a typical immediate risk tied to being large for gestational age; hypothermia can occur but isn’t the hallmark risk here; hypocalcemia can occur in infants of diabetic mothers, but hypoglycemia is the more common and clinically important concern to monitor in a term, large baby.