A 1-hour-old newborn girl is evaluated in the nursery for respiratory distress. She was born at 34 weeks gestation to a 17-year-old primigravida woman who did not receive
prenatal care. The patient’s temperature is 36.4°C (97.5°F),
pulse is 128/min, respirations are 80/min, and
blood pressure is 75/30 mmHg. Oxygen saturation is 85% on room air. On physical examination, she appears cyanotic, and
subcostal retractions and nasal flaring are noted. The nasal tip is flattened, the
ears are low-set, and the chin is small and retracted backward. Appropriate treatment is initiated. Which of the following is the most likely underlying cause for this patient’s condition?
