Infant of diabetic mother with weight 3.8 kg presented with seizures after 16 hours of bih. Which of the following is the most likely cause?
**Core Concept**
Hypoglycemia is a critical condition in neonates, particularly in infants of diabetic mothers (IDMs), due to the transplacental passage of glucose and insulin. This can lead to an exaggerated surge in insulin levels after birth, causing hypoglycemia.
**Why the Correct Answer is Right**
In infants of diabetic mothers, the high glucose levels in utero stimulate the fetal pancreas to produce excess insulin. After birth, when the newborn is separated from the placenta, the glucose supply is cut off, and the insulin levels remain elevated. This results in hypoglycemia, which can be severe enough to cause seizures. The correct answer, **Hypoglycemia**, is a direct consequence of the pathophysiological changes occurring in IDMs.
**Why Each Wrong Option is Incorrect**
**Option A:** **Hypocalcemia** - Although hypocalcemia can cause seizures in neonates, it is not directly related to the pathophysiology of IDMs.
**Option B:** **Hypomagnesemia** - Like hypocalcemia, hypomagnesemia can cause seizures, but it is not the primary concern in IDMs.
**Option C:** **Intraventricular Hemorrhage (IVH)** - IVH is a potential complication of prematurity, but it is not directly related to the metabolic disturbances seen in IDMs.
**Clinical Pearl / High-Yield Fact**
IDMs are at risk of hypoglycemia due to the transplacental passage of glucose and insulin. This highlights the importance of monitoring glucose levels in these infants, especially in the first 24 hours after birth.
**Correct Answer: A. Hypoglycemia**