A preterm infant at 29 weeks delivers before betamethasone can be given. Which condition is most likely to develop in the newborn?

• A. Chlamydia
• B. Hypoglycemia
• C. Hyperbilirubinemia
• D. Respiratory depression

Answer: (D)

Antenatal corticosteroids like betamethasone speed up fetal lung maturation by boosting surfactant production, which keeps alveoli open and improves gas exchange after birth. When delivery happens before this treatment can be given, the preterm infant often lacks enough surfactant, leading to alveolar collapse, inefficient oxygenation, and increased work of breathing. This combination manifests as respiratory compromise—often described clinically as respiratory depression or respiratory distress syndrome in the newborn. Among the listed possibilities, this respiratory problem is the most likely immediate issue for a 29-week preterm infant who did not receive antenatal steroids. Chlamydia exposure, hypoglycemia, and hyperbilirubinemia are possible concerns in preterm infants, but they are not as directly tied to the absence of steroid-driven lung maturation as the risk of surfactant-deficient respiratory impairment.