What is the main concern for infants born to mothers with uncontrolled diabetes?

Infants born to mothers with uncontrolled diabetes are primarily at risk for macrosomia, which refers to an excessive birth weight. This condition occurs because high levels of glucose in the maternal bloodstream can cross the placenta, leading to elevated blood sugar levels in the fetus. In response, the fetal pancreas produces more insulin, which promotes the accumulation of fat and results in larger body size. This has crucial implications for delivery, as macrosomic infants may encounter complications such as birth injuries or the need for cesarean delivery due to their size.

While the other choices, such as hypoglycemia, jaundice, and respiratory distress, can indeed affect infants of diabetic mothers, they are not as immediate or direct a concern as macrosomia. For example, hypoglycemia might occur shortly after birth when an infant's glucose levels drop due to the sudden lack of maternal glucose supply, but it is typically manageable. Jaundice may happen due to the breakdown of red blood cells, often linked to various factors, and respiratory distress can arise from numerous causes unrelated to maternal diabetes. Hence, macrosomia remains the primary concern because of its far-reaching implications for both maternal and neonatal health.