Which of the following babies has the least risk of developing hypoglycaemia?
**Core Concept**
Hypoglycemia in newborns is a critical condition that can occur due to the transition from fetal to adult metabolism, particularly after birth. The primary concern is the rapid decrease in glucose levels, which can be exacerbated by various factors such as maternal diabetes, gestational diabetes, or large-for-gestational-age (LGA) babies.
**Why the Correct Answer is Right**
Premature infants, especially those born before 34 weeks of gestation, tend to have a lower risk of developing hypoglycemia. This is because their liver stores glycogen are more depleted before birth, and they have a higher glucose uptake due to increased insulin levels in the placenta. Moreover, premature infants often have a higher rate of glucose production in the liver, which helps maintain stable glucose levels.
**Why Each Wrong Option is Incorrect**
**Option A:** Babies born to diabetic mothers are at a higher risk of developing hypoglycemia due to the excessive insulin stimulation during fetal life, leading to increased glycogen stores and insulin resistance.
**Option B:** Large-for-gestational-age (LGA) babies are at a higher risk of developing hypoglycemia due to the increased glycogen stores and insulin resistance, making it difficult for their liver to adapt to the postnatal environment.
**Option C:** Babies with intrauterine growth restriction (IUGR) are at a higher risk of developing hypoglycemia due to the reduced glycogen stores and decreased glucose production in the liver, making them more susceptible to hypoglycemia.
**Clinical Pearl / High-Yield Fact**
It's essential to remember that premature infants, especially those born before 34 weeks, have a unique metabolic profile that can make them less susceptible to hypoglycemia. However, it's crucial to monitor glucose levels closely in all newborns, especially those with a high-risk profile.
**Correct Answer: C. Babies with intrauterine growth restriction (IUGR) are at a higher risk of developing hypoglycaemia.