Question

A 3.8 kg baby of a diabetic mother developed seizures 16 hours after birth. The most probable cause is?

• A. Hypoglycemia
• B. Hypocalcemia
• C. Birth asphyxia
• D. Intraventricular hemorrhage

Hint:

In an IDM, glucose falls within hours while calcium drops later (after about 72 hours).

Answer 1

The Correct Option is A

Anchor the answer on two facts: the baby is an infant of a diabetic mother and the seizure occurred at 16 hours of age. Chronic exposure to high maternal glucose in utero trains the fetal pancreas to oversecrete insulin, so the newborn arrives hyperinsulinemic and macrosomic, exactly fitting the 3.8 kg weight. The instant the umbilical glucose supply is cut at delivery, the baby's still-elevated insulin keeps pushing glucose into cells, and blood sugar plummets within hours. This early, insulin-driven hypoglycemia is the classic cause of neonatal seizures in the first day of life and squarely covers a 16-hour presentation. The competing metabolic option, hypocalcemia, is genuinely common in these babies but runs on a different clock, surfacing typically beyond the first day and most often after roughly three days, so it is the better answer only for later seizures. The non-metabolic options need supporting context that is absent here: birth asphyxia demands a history of a compromised delivery and an encephalopathic course, and intraventricular hemorrhage is predominantly a complication of prematurity rather than a term, large IDM. With the clock reading 16 hours, the metabolic derangement that strikes earliest is the one to choose. $\text{IDM} + \text{seizure at 16 h} \Rightarrow \text{early hypoglycemia}$.\[\boxed{\text{Hypoglycemia}}\]