A term growth-restricted female infant with asymmetric crying facies presents at 6 weeks of age with poor weight gain and respiratory distress.

  • Born to a 34-year-old gravida 3, para 2 woman.

  • Prenatal course significant for maternal history of chronic hypertension treated with labetalol and aspirin. Pregnancy complicated by intrauterine growth restriction.

  • Estimated gestational age: 37 1/7 weeks.

  • Repeat cesarean delivery.

  • Prenatal maternal laboratory findings: Group B Streptococcus unknown, screened positive for COVID-19 – noted to be asymptomatic.

  • Apgar scores 7 and 9 at 1 and 5 minutes, respectively.

The infant was admitted to an outside hospital NICU immediately after birth for low birthweight. The infant did not require respiratory support and a sepsis evaluation was negative. COVID tests performed at 24 and 48 hours of age were negative. The infant’s growth restriction was presumed to be related to maternal hypertension, but no placental pathology was found. As a result of...

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