What is the primary neonatal complication associated with diabetes during pregnancy?

Hypoglycemia is a primary neonatal complication associated with diabetes during pregnancy due to the metabolic environment created by maternal hyperglycemia. When a mother has diabetes, particularly uncontrolled, her blood glucose levels are often elevated. In response, the fetus produces excessive insulin to manage the high glucose levels it is exposed to in utero. After birth, when the abrupt supply of maternal glucose is cut off, this hyperinsulinemic state can lead to a significant drop in the newborn's blood sugar levels, resulting in hypoglycemia.

This condition can manifest with various symptoms in the newborn, such as lethargy, poor feeding, and irritability, and if not quickly addressed, it can lead to more severe neurological complications. Monitoring blood glucose levels in the neonatal period is therefore essential for infants born to mothers with diabetes, especially when maternal diabetes management was suboptimal during pregnancy.

While other options may also present in certain contexts, hypoglycemia specifically and primarily arises as a direct consequence of the interplay between maternal diabetes and fetal insulin regulation.