阿摩線上測驗
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
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統計： A(23), B(130), C(124), D(490), E(0) #3261069
統計： A(23), B(130), C(124), D(490), E(0) #3261069
詳解 (共 6 筆)
JuJu
#7423884
FC說GDM生出的巨嬰有3高1低，高CO2(高insulin會破壞肺部surfactant的合成)，高RBC，高bilirubin，低血糖(因為子宮裡有媽媽的高血糖，baby高胰島素，出生後只能用自己的儲備，很快就低血糖了)
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在多加2低，低血鈣和低血鎂
因為高血糖的osmotic diuresis，媽媽把鎂離子尿掉了，baby跟著媽媽一起低血鎂
低血鎂抑制baby的PTH，baby低血鈣
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所以3高3低
高CO2，高RBC，高bilirubin
低血糖、低血鈣、滴血鎂
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HJ C
#6485157
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Maternal hyperglycemia during pregnancy:
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Leads to fetal hyperglycemia, stimulating the fetal pancreas to produce excess insulin (→ fetal hyperinsulinemia).
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Magnesium and calcium metabolism disturbance:
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Maternal hyperglycemia disrupts calcium-phosphorus metabolism and increases urinary magnesium loss.
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This results in maternal hypomagnesemia, which leads to fetal hypomagnesemia.
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Fetal hypomagnesemia impairs parathyroid hormone (PTH) synthesis and response in the neonate.
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At birth:
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The sudden loss of maternal calcium supply combined with low fetal PTH activity leads to:
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Reduced calcium mobilization from bone
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Decreased renal calcium reabsorption
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Ultimately causing neonatal hypocalcemia
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