5.下列關於糖尿病母親所生嬰兒（infant of diabetic mothers）的敘述，何者最不適當？
(A)約36～45%為large for gestational age（LGA），若有LGA，則產傷（birth trauma）及生產窒息（birth asphyxia）風險較高
(B)可能造成紅血球增多症（polycythemia），發生高膽紅素血症（hyperbilirubinemia）的機率也會上升
(C)可能有心臟擴大（cardiomegaly）及心室中隔肥厚（interventricular septal hypertrophy）
(D)出生後容易有低血糖（hypoglycemia）、高血鈣（hypercalcemia），並且經常表現出肌張力低下、昏睡、 吸吮力差等症狀

Maternal hyperglycemia during pregnancy:

• Leads to fetal hyperglycemia, stimulating the fetal pancreas to produce excess insulin (→ fetal hyperinsulinemia).

Magnesium and calcium metabolism disturbance:

• Maternal hyperglycemia disrupts calcium-phosphorus metabolism and increases urinary magnesium loss.

• This results in maternal hypomagnesemia, which leads to fetal hypomagnesemia.

• Fetal hypomagnesemia impairs parathyroid hormone (PTH) synthesis and response in the neonate.

At birth:

• The sudden loss of maternal calcium supply combined with low fetal PTH activity leads to:

  • Reduced calcium mobilization from bone

  • Decreased renal calcium reabsorption

  • Ultimately causing neonatal hypocalcemia