A 1-Hour-Old Boy Is Evaluated in the Newborn Nursery for Microcephaly

question 98

Multiple Choice

A 1-hour-old boy is evaluated in the newborn nursery for microcephaly.  He was born via spontaneous vaginal delivery to a 26-year-old woman who did not receive prenatal care.  The mother has no known chronic medical conditions.  On physical examination, the boy's occipitofrontal circumference is >3 standard deviations below the mean.  The anterior fontanelle is closed, and the skull is partially collapsed.  Cardiopulmonary examination is normal.  The abdomen is soft, nontender, and has no palpable masses.  Multiple contractures and a right club foot are noted.  The infant has marked hypertonia.  Imaging shows thin cerebral cortices and multiple intracranial calcifications within the cerebral cortex.  Which of the following maternal risk factors is most commonly associated with this infant's presentation?

• A)Consumption of unpasteurized dairy products
• B)Daily alcohol consumption
• C)Inadequate folic acid supplementation
• D)Nonadherence to vaccination schedule
• E)Travel to a tropical, mosquito-infested region

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