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# Infants of Diabetic Mother (IDM) Infants of diabetic mothers often present with: - Birth trauma secondary to cephalopelvic disproportion, including shoulder dislocation. - Hypoglycemia from sudden withdrawal of maternal glucose and elevated insulin in the infant. - Respiratory distress syndrome...

# Infants of Diabetic Mother (IDM) Infants of diabetic mothers often present with: - Birth trauma secondary to cephalopelvic disproportion, including shoulder dislocation. - Hypoglycemia from sudden withdrawal of maternal glucose and elevated insulin in the infant. - Respiratory distress syndrome because elevated insulin inhibits surfactant production. - Polycythemia (excessive red blood cell production) and hyperviscosity because elevated insulin and glucose increase the metabolic rate and oxygen consumption. - Iron deficiency because polycythemia leaches iron from the heart and brain. - Hyperbilirubinemia because of increased red blood cell destruction after birth. - Cardiovascular malformations, like intraventricular hypertrophy with outflow tract obstruction, transposition of the great arteries, ventral septal defects, and coarctation of the aorta. - Congenital malformations, like anencephaly, spina bifida, renal agenesis, and duodenal atresia. - Electrolyte abnormalities, like hypocalcemia and hypomagnesemia. - Macrosomia (>4000 to 4500 g) because of increased glucose transfer across the placenta. # High-Risk Infant ## Acute Hypoglycemia/Hyperinsulinism Acute hypoglycemia/hyperinsulinism can cause damage to the central nervous and cardiopulmonary systems, interfering with development of the brain and causing neurological impairment. Causes include: - Persistent hyperinsulinemic hypoglycemia of infancy (PHHI) in infants of diabetic mothers, usually apparent in the first 3 months. - Genetic defects in chromosome 11 (short arm). - Severe infections, such as Gram-negative sepsis, endotoxic shock. - Maternal tocolytic administration. ### Symptoms are as follows: - Blood glucose