What complication arises from excessive fetal exposure to insulin in a newborn?

Excessive fetal exposure to insulin can lead to neonatal respiratory distress syndrome (NRDS). This condition arises because high levels of insulin in the fetus can lead to hyperplasia of the fetal pancreas and the subsequent increase in fetal growth (macrosomia). Babies born to mothers with poorly controlled diabetes are often larger and can have underdeveloped lungs due to the impact of insulin on surfactant production. Surfactant is a substance that reduces surface tension in the lungs and is essential for normal respiration after birth. If a newborn’s lungs are not adequately developed, it can lead to difficulties in breathing and the onset of neonatal respiratory distress syndrome.

Other options are not directly linked to complications arising from excessive fetal insulin exposure. For example, increased gluconeogenesis and inadequate glycogen stores are more related to the metabolic state of the newborn or the mother rather than a direct effect of fetal insulin exposure. Decreased insulin secretion would not occur as the fetus produces more insulin in response to high levels of glucose, not less. Therefore, the primary complication of excessive fetal insulin exposure is indeed neonatal respiratory distress syndrome, highlighting the importance of proper management of maternal diabetes during pregnancy.