A 36-week gestation infant is delivered via cesarean section because of macrosomia and fetal distress. The mother has class D pregestational diabetes (insulin
dependent, with vascular disease); her hemoglobin A1c is 15% (normal 7%).
This infant is at risk for hypocalcemia, cardiomyopathy, polycythemia, and
which of the following?
- A. Congenital dislocated hip
- B. Dacryostenosis
- C. Respiratory distress syndrome
- D. Hyperglycemia
- E. Pneumothorax
C. Infants born to mothers with poorly controlled diabetes are at risk for respiratory distress syndrome (surfactant deficiency) even at near-term gestational
ages. The maternal hyperglycemia stimulates fetal hyperinsulinism, which has
an antagonistic effect on surfactant production.