A macrosomic newborn is at risk for which immediate complication requiring frequent monitoring after birth?

• A. Hypoglycemia
• B. Hyperkalemia
• C. Jaundice
• D. Respiratory distress

Answer: (A)

Macrosomic babies, especially those born to mothers with diabetes, often have high insulin levels. After birth, the placenta no longer supplies glucose, but the infant may still have circulating insulin, so glucose is taken up into tissues faster than it’s produced by the liver. This rapid drop in blood glucose can occur quickly and may be asymptomatic at first, so frequent monitoring in the hours after birth is essential to catch and treat hypoglycemia early and prevent potential neurodevelopmental issues. While respiratory problems can occur in infants of diabetic mothers and jaundice can develop in many newborns, hypoglycemia is the most immediate, specific risk requiring close glucose monitoring right after birth.