A female infant is born at 40 weeks and 6 days of gestation to a 36-year-old gravida 3 para 3 mother via cesarean section because of failure to progress. Membranes rupture at delivery, with thick meconium but no cardiotocographic abnormalities. Maternal medical history was significant for methamphetamine (MTA) abuse during pregnancy, but she denies other illicit drug use. There is no history of oligohydramnios, chorioamnionitis, antepartum hemorrhage, gestational diabetes, preeclampsia, or maternal hypertension.

The infant’s Apgar scores are 5, 7, and 9 at 1, 5, and 10 minutes, respectively. At birth, the infant is flaccid and has persistent apnea that requires positive pressure ventilation followed by endotracheal intubation. She is, therefore, transferred to the NICU on mechanical ventilation. On admission, her cord blood gas measurement shows a pH of 7.22, Pao2 48 mm Hg (6.4 kPa), Paco2 31.5 mm Hg (4.2 kPa), bicarbonate 20.2 mEq/L (20.2...

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