Large-for-gestational-age infant and infants of diabetic mothers — case

Case summary

A term male infant is born at 39 weeks to a 32-year-old multipara whose pregnancy was complicated by gestational diabetes diagnosed at 26 weeks and managed with metformin, with a high third-trimester HbA1c. Serial growth scans showed a rising estimated fetal weight above the 97th centile, prompting a planned delivery. Birthweight is 4400 g (above the 97th centile on an INTERGROWTH-21st chart). He is plump and plethoric with disproportionate shoulder and truncal adiposity and a palpable liver. At two hours of age he is jittery and a pre-feed glucose is low after a breastfeed. ^{[3] [1]}