Your patient has gestational diabetes and she is currently on insulin 24 units in the morning and at night. She is worried about her baby and what will happen after the baby is born. In your education of the patient, you explain what will occur after the baby is born. Which major neonatal complication is carefully monitored after the birth of the infant of a diabetic mother?

Choice A reason: Congenital anomalies of the central nervous system are not a common complication of GDM, as they usually occur in the first trimester, before GDM develops. However, GDM can increase the risk of other congenital anomalies, such as cardiac defects or neural tube defects.

Choice B reason: Preterm birth is a possible complication of GDM, as it can be caused by maternal hypertension, preeclampsia, or placental abruption. However, it is not the most likely complication, as GDM can also delay the onset of labor and prolong the pregnancy.

Choice C reason: Low birth weight is not a typical complication of GDM, as it is more associated with intrauterine growth restriction (IUGR), which is caused by placental insufficiency. GDM can cause the opposite problem, which is excessive fetal growth.

Choice D reason: Macrosomia is the most common complication of GDM, as it is defined as a birth weight of more than 4,000 grams (8.8 pounds). It is caused by the excess glucose crossing the placenta and stimulating the fetal insulin production, which leads to increased fat deposition and organ enlargement. Macrosomia can increase the risk of birth trauma, shoulder dystocia, and neonatal hypoglycemia.

Choice A reason: Human immunodeficiency virus (HIV) is incorrect because it is not characterized by recurrent episodes. It is a chronic infection that progressively damages the immune system and can lead to acquired immunodeficiency syndrome (AIDS).

Choice B reason: Herpes simplex virus (HSV) 2 is correct because it is characterized by recurrent episodes. It is a viral infection that causes genital herpes, which is marked by painful blisters and sores in the genital area. The virus remains dormant in the nerve cells and can reactivate periodically, causing outbreaks.

Choice C reason: Human papillomavirus (HPV) is incorrect because it is not characterized by recurrent episodes. It is a viral infection that causes genital warts and cervical cancer. The virus can persist in the body for a long time, but it does not cause repeated symptoms.

Choice D reason: Cytomegalovirus (CMV) is incorrect because it is not characterized by recurrent episodes. It is a viral infection that usually causes mild or no symptoms in healthy people, but can be serious in people with weakened immune systems or unborn babies. The virus can remain latent in the body, but it does not cause flare-ups.