A 3.8 kg baby of a diabetic mother developed seizures 32 hours after birth. The most probable cause would be?

Ans. A. Hypoglycemia* The neonate has seizures developed at around 32 hrs after birth. There are two possibilities in this neonate i.e. hypoglycemia and hypocalcemia.* Hypoglycemia in first 18-36 hrs is usually due to transient neonatal hypoglycemia and after 36 hrs metabolic and other causes are likely.* Hypoglycemia develops in about 25-50% of infants of diabetic mothers and 15-25% of infants of mothers with gestational diabetes, but only a small percentage of these infants become symptomatic. The probability of hypoglycemia developing in the infant increases, and glucose levels are likely to be lower at higher cord or maternal fasting blood glucose levels.* In those infants with HIE who have seizures, onset of seizures is generally within the first 24 hours after birth. However, the timing of onset is not a reliable indicator of the timing of the neurologic injury.* Seizures due to intracranial hemorrhage may also be associated with hypoxic-ischemic or traumatic injury since these events are frequently associated with each other.* Onset of seizures due to subarachnoid hemorrhage or subdural hemorrhage is usually the second or third day of life, while those due to germinal matrix-intraventricular hemorrhage present after the third day.